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Gretchen Michelle Bly, DC
Chiropractor in Rexburg, Idaho
NPI 1073630984

Gretchen Michelle Bly is a Chiropractor based in Rexburg, ID. Gretchen Michelle Bly practices in Rexburg, ID and has the professional credentials of DC. The NPI Number for Gretchen Michelle Bly is 1073630984 and holds a License No. CHIA-1037 (Idaho).

The current practice location address for Gretchen Michelle Bly is 105 W Main St, Rexburg, ID and can be reached out via phone at 208-356-6772.

Location: 105 W Main St, Rexburg, ID, 83440-2634
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073630984
Provider Name
Gretchen Michelle Bly
Credential
DC
Provider Entity Type
Individual
Gender
Female
Address
105 W Main St, Rexburg, ID, 83440-2634
Phone Number
208-356-6772
Fax Number
Provider Enumeration Date
03/24/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
16711661 01 ID MEDICARE GROUP PTAN
806710900 05 ID
16753471 01 ID MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
105 W Main St
City
Rexburg
State
Idaho
Zip
83440-2634
Phone Number
208-356-6772
Fax Number
person
Provider Business Mailing Address Details
Address
105 W Main St
City
Rexburg
State
Idaho
Zip
83440-2634
Phone Number
208-356-6772
Fax Number
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
CHIA-1037 (Idaho)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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