Russell C Allen | Meridian, ID • PECOS Search

Russell C Allen

Chiropractor

Chiropractic Providers

4771 N Summit Way Ste 110, Meridian, ID 83646-5017

PECOS Enrollment

Based on the most recent information from CMS, provider Russell C Allen does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1093730400
Provider Type
Individual
Full Name
Allen, Russell C
Title
Dr.
Credential
DC

Gender
Male
Sole Proprietor
No
Enumeration Date
7/13/2006
Last Updated
10/23/2023

Contact Information

Practice Location

4771 N Summit Way Ste 110, Meridian, ID 83646-5017

Unlisted Fax

Mailing Location

4771 N Summit Way Ste 110, Meridian, ID 83646-5017

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 111N00000X Primary	Description Chiropractor Chiropractic Providers	License CHIA1018 Idaho