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1053646414
BRYAN G BUMGARNER
BOISE, ID
NPI
1053646414
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID 30983)
Enumeration Date
2009-10-02
Last Update Date
2023-01-11
Business Address
BRYAN G BUMGARNER LCSW
500 W FORT ST B-114
BOISE, ID 83702-4501
Phone number: 208-422-1000
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Mailing Address
BRYAN G BUMGARNER LCSW
500 W FORT ST B-114/RIVER ST
BOISE, ID 83702-4501
Phone number: 208-422-1000
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