Provider Demographics
NPI:1801695481
Name:POBRAN, LLOLYN (DC, CHT)
Entity type:Individual
Prefix:
First Name:LLOLYN
Middle Name:
Last Name:POBRAN
Suffix:
Gender:
Credentials:DC, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4473 N MOUNT CARROL ST
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-9326
Mailing Address - Country:US
Mailing Address - Phone:208-964-3777
Mailing Address - Fax:
Practice Address - Street 1:3895 N SCHREIBER WAY STE 600
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-5240
Practice Address - Country:US
Practice Address - Phone:208-818-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC11500111NN1001X
IDDC11500111NN1001X
CADC1150111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition