CHRISTOPHER JOSEPH BANTA

REXBURG, ID
NPI1164545877
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103TR0400X Psychologist, Rehabilitation
Enumeration Date2007-04-09
Last Update Date2007-07-08
Business Address
Mr. CHRISTOPHER JOSEPH BANTA BA Psychology
218 DIVIDEND DR STE 3
REXBURG, ID 83440-3510
Phone number: 208-359-9683
Mailing Address
Mr. CHRISTOPHER JOSEPH BANTA BA Psychology
635 ANGELA DR
REXBURG, ID 83440-1422
Phone number: 208-351-0149
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