Provider Demographics
NPI:1740444249
Name:JAMES E. VANCHO, DC, PC
Entity type:Organization
Organization Name:JAMES E. VANCHO, DC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:VANCHO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-773-1868
Mailing Address - Street 1:102 W 11TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-9255
Mailing Address - Country:US
Mailing Address - Phone:208-773-1868
Mailing Address - Fax:208-773-6956
Practice Address - Street 1:102 W 11TH AVE STE B
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-9255
Practice Address - Country:US
Practice Address - Phone:208-773-1868
Practice Address - Fax:208-773-6956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA 654111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1672624Medicare PIN