Provider Demographics
NPI:1740309442
Name:HONOVICH, YVONNE DAVIDSON (DC)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:DAVIDSON
Last Name:HONOVICH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LENDY
Other - Middle Name:YVONNE
Other - Last Name:DAVIDSON-HONOVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:5906 S SCHOONER PL
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-9091
Mailing Address - Country:US
Mailing Address - Phone:208-385-9180
Mailing Address - Fax:
Practice Address - Street 1:2300 S ORCHARD ST
Practice Address - Street 2:SUITE A
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-6722
Practice Address - Country:US
Practice Address - Phone:208-383-3703
Practice Address - Fax:208-383-3702
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor