Provider Demographics
NPI:1447234620
Name:MEISSNER, SCOTT REGAN (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:REGAN
Last Name:MEISSNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10159 W. OVERLAND RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709
Mailing Address - Country:US
Mailing Address - Phone:208-322-0051
Mailing Address - Fax:
Practice Address - Street 1:10159 W OVERLAND RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709
Practice Address - Country:US
Practice Address - Phone:208-322-0051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA460-3111N00000X
IDCHIA-460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010007462OtherREGENCE OF IDAHO
IDC460-3OtherBLUE CROSS OF IDAHO
ID612716OtherUNITED HEALTHCARE
ID000010007462OtherREGENCE OF IDAHO
IDC460-3OtherBLUE CROSS OF IDAHO