Provider Demographics
NPI:1497816144
Name:NORCE, BRIAN LEE (DC)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:LEE
Last Name:NORCE
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 1:7760 ABERCROMBIE CT
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815
Mailing Address - Country:US
Mailing Address - Phone:208-666-1000
Mailing Address - Fax:208-665-7749
Practice Address - Street 1:213 W APPLEWAY
Practice Address - Street 2:STE 7
Practice Address - City:COEUR DALENE
Practice Address - State:ID
Practice Address - Zip Code:83815
Practice Address - Country:US
Practice Address - Phone:208-666-1000
Practice Address - Fax:208-665-7749
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA1029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807389500Medicaid
U95881Medicare UPIN
ID807389500Medicaid