LEWISTON ORTHOPAEDIC ASSOCIATES PA
Neuromusculoskeletal Medicine, Sports Medicine

NPI Profile for LEWISTON ORTHOPAEDIC ASSOCIATES PA in LEWISTON, ID.

A Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

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Contact Information

LEWISTON ORTHOPAEDIC ASSOCIATES PA

320 WARNER DR
LEWISTON, ID 83501-4441

Phone: 208-743-3523
Fax: 208-746-8741
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Neuromusculoskeletal Medicine, Sports Medicine	204C00000X	12	Physician/Osteopathic Manipulative Medicine
Medical Specialty	261QM2500X
Multi-Specialty	261QM1300X	70	Clinic or Group Practice

Indicates primary specialty

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NPI Profile & details for LEWISTON ORTHOPAEDIC ASSOCIATES PA · (Female)

NPI #	`1215095252`
Status	Active
Credentials
Entity	Individual
Enumeration date	12/04/2006
Last updated	01/24/2017 - About 9 years ago
Sole proprietor ¹	Not specified
Identifiers	ID License # BL04-213478 ID Medicaid 002397200 WA Medicaid 7849003 ID Other 89409 BCI ID Other 000010026897 REGENCE BLUESHIELD IDAHO
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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