Provider Demographics
NPI:1790237956
Name:TERRAZAS, OSCAR JR (DC)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:
Last Name:TERRAZAS
Suffix:JR
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 1:5244 W OVERLAND RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-2636
Mailing Address - Country:US
Mailing Address - Phone:505-717-6842
Mailing Address - Fax:
Practice Address - Street 1:5244 W OVERLAND RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-2636
Practice Address - Country:US
Practice Address - Phone:505-717-6842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA 1712111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor