Provider Demographics
NPI:1679567564
Name:WEAR & ASSOCIATES DC PA
Entity Type:Organization
Organization Name:WEAR & ASSOCIATES DC PA
Other - Org Name:DBA: NAMPA CHIROPRACTICE & WELLNESS CENTER & DR. JAMES W. WEAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:WEAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-466-5459
Mailing Address - Street 1:124 12TH AVE RD
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5074
Mailing Address - Country:US
Mailing Address - Phone:208-466-5459
Mailing Address - Fax:208-466-5803
Practice Address - Street 1:124 12TH AVE RD
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-5074
Practice Address - Country:US
Practice Address - Phone:208-466-5459
Practice Address - Fax:208-466-5803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA276111N00000X
IDACC106171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C9487OtherBLUE CROSS OF IDAHO
00001008304OtherBLUE SHIELD OF IDAHO
CS1067OtherPALMETTO GBA
ID00001008304OtherBLUE SHIELD
IDC3100OtherBLUE CROSS
CS1067OtherPALMETTO GBA