Provider Demographics
NPI:1689483166
Name:STRAHL, REID JOHNATHAN (DC)
Entity type:Individual
Prefix:
First Name:REID
Middle Name:JOHNATHAN
Last Name:STRAHL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 ASHMENT AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-5802
Mailing Address - Country:US
Mailing Address - Phone:208-881-9066
Mailing Address - Fax:208-497-0856
Practice Address - Street 1:237 N 2ND E STE 106
Practice Address - Street 2:
Practice Address - City:REXBURG
Practice Address - State:ID
Practice Address - Zip Code:83440-4977
Practice Address - Country:US
Practice Address - Phone:208-881-9066
Practice Address - Fax:208-881-5514
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID9261255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor