Provider Demographics
NPI:1598836843
Name:PFAFF, BRIAN (CHIROPRACTOR)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:PFAFF
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 N CURTIS RD STE 110
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-1248
Mailing Address - Country:US
Mailing Address - Phone:208-291-5566
Mailing Address - Fax:208-789-2282
Practice Address - Street 1:1070 N CURTIS RD STE 110
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-1248
Practice Address - Country:US
Practice Address - Phone:208-291-5566
Practice Address - Fax:208-789-2282
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA1065111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111N00000XChiropractic ProvidersChiropractor