Provider Demographics
NPI:1356985816
Name:SYNERGY HEALTH AND WELLNESS
Entity type:Organization
Organization Name:SYNERGY HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-252-9123
Mailing Address - Street 1:951 E PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-6566
Mailing Address - Country:US
Mailing Address - Phone:503-756-5317
Mailing Address - Fax:
Practice Address - Street 1:951 E PLAZA DR
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-6566
Practice Address - Country:US
Practice Address - Phone:208-252-9123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty