Provider Demographics
NPI:1003249608
Name:WENTWORTH, EMILY R (DC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:R
Last Name:WENTWORTH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 N CALGARY CT STE 1
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-4906
Mailing Address - Country:US
Mailing Address - Phone:509-398-1408
Mailing Address - Fax:208-777-4315
Practice Address - Street 1:609 N CALGARY CT STE 1
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-4906
Practice Address - Country:US
Practice Address - Phone:208-777-4305
Practice Address - Fax:208-777-4315
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2025-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1637111N00000X
ID5771780175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No175F00000XOther Service ProvidersNaturopath