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1154507796
GLENN ROSE
IDAHO FALLS, ID
NPI
1154507796
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: ID LSW1887)
Enumeration Date
2008-01-14
Last Update Date
2008-01-14
Business Address
Mr. GLENN ROSE LSW1887
1740 E 17TH ST STE B
IDAHO FALLS, ID 83404-6375
Phone number: 208-529-8832
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Mailing Address
Mr. GLENN ROSE LSW1887
1740 E 17TH ST STE B
IDAHO FALLS, ID 83404-6375
Phone number: 208-529-8832
Copy
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