| Legacy Health Partners | |
|
333 S. Woodruff Ave, Idaho Falls, ID 83401 | |
| (208) 522-2591 | |
| (208) 522-2591 |
| Full Name | Legacy Health Partners |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 333 S. Woodruff Ave, Idaho Falls, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184801946 | NPI | - | NPPES |
| 1369151 | Other | ID | MEDICARE GROUP # |
| C9672 | Other | ID | BLUE CROSS GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CHIA 1163 (Idaho) | Primary |
| Provider Name | Gary C Wight |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1215012554 PECOS PAC ID: 6406866870 Enrollment ID: I20060501000487 |
| Provider Name | Trevor R Bartlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639442973 PECOS PAC ID: 1456515840 Enrollment ID: I20120615000028 |
| Provider Name | Tristan M King |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245619576 PECOS PAC ID: 4183930456 Enrollment ID: I20150901001531 |
| Provider Name | Miranda Holwege |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1215462304 PECOS PAC ID: 3577809581 Enrollment ID: I20190111002943 |
| Provider Name | Joseph M Wight |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851645634 PECOS PAC ID: 1759628845 Enrollment ID: I20190128002233 |
| Provider Name | Ryan Mcgraw |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1417729500 PECOS PAC ID: 7618324153 Enrollment ID: I20231106002030 |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Health Partners 333 S. Woodruff Ave, Idaho Falls, ID 83401 Ph: (208) 522-2591 | Legacy Health Partners 333 S. Woodruff Ave, Idaho Falls, ID 83401 Ph: (208) 522-2591 |
Zachary Steven Lovell, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 740 S Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-542-9111 Fax: 208-542-9114 | |
Dr. Rod T. Stocking, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1789 W. Broadway, Idaho Falls, ID 83402 Phone: 208-522-4200 Fax: 208-522-4233 | |
Dr. Freddie L. Sermon, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1880e 17th St, Idaho Falls, ID 83404 Phone: 208-206-0237 | |
William E Clement, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 657 S Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-552-9886 Fax: 208-552-9843 | |
Angela J Sackett, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1278 S Woodruff Ave, Idaho Falls, ID 83404 Phone: 208-528-6010 Fax: 208-528-6011 | |
Bob Phillip Heaton, DC Chiropractor Medicare: Medicare Enrolled Practice Location: 1320 S Ammon Road, Idaho Falls, ID 83406 Phone: 208-529-2084 Fax: 208-529-2084 | |
Dr. Michael Chad Miller, D.C. Chiropractor Medicare: May Accept Medicare Assignments Practice Location: 3419 Merlin Dr, Idaho Falls, ID 83404 Phone: 208-552-8866 Fax: 208-552-8867 |