Provider Demographics
NPI:1750504163
Name:HORCH, VICTOR HERBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:HERBERT
Last Name:HORCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13176 W PERSIMMON LN
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-1986
Mailing Address - Country:US
Mailing Address - Phone:208-321-0044
Mailing Address - Fax:208-938-9807
Practice Address - Street 1:13176 W PERSIMMON LN
Practice Address - Street 2:SUITE 110
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-1986
Practice Address - Country:US
Practice Address - Phone:208-321-0044
Practice Address - Fax:208-938-9807
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDCHIA755111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1673256Medicare ID - Type Unspecified