Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Thor Stephen Bostrom, DC

Individual provider Chiropractor · NPI 1609479419

Dr. Thor Stephen Bostrom, DC is a Chiropractic in Coeur D Alene, Idaho. Qualified in 2016, 10 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Montana.

Years since qualifying
10
Licensed in
MT
In the registry since
2020
What do these letters mean?
DC — Doctor of Chiropractic
A licensed chiropractor.

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Practice location Address checks out

810 E Sherman Ave
Coeur D Alene, ID 83814-4149
Phone: (208) 665-2293
Fax: (208) 908-6038
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Chiropractor (primary) Taxonomy 111N00000X · Licence CHI-CHI-LIC-6726 (MT)

Record details

NPI number1609479419
Entity typeIndividual (Type 1)
GenderMale
Credentials DC
Sole proprietorYes
NPI enumeratedNovember 16, 2020
Last updated in NPPESMarch 30, 2023
Certification dateMarch 30, 2023
Mailing address4156 N Player Dr, Coeur D Alene, ID 83815-1603

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCHIROPRACTIC
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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