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1194485607
ADAM BOOMER
MISSOULA, MT
NPI
1194485607
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MT BBh-SWLC-LIC-53919)
Enumeration Date
2021-12-23
Last Update Date
2021-12-23
Business Address
ADAM BOOMER
2750 TERRACE DR
MISSOULA, MT 59803-9732
Phone number: 406-830-5095
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Mailing Address
ADAM BOOMER
2750 TERRACE DR
MISSOULA, MT 59803-9732
Phone number:
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