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1205213246
ADAM NIELSEN BURCH
IDAHO FALLS, ID
NPI
1205213246
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology Psychiatry
(Licence: ID O-1364)
Enumeration Date
2015-04-28
Last Update Date
2020-07-29
Business Address
ADAM NIELSEN BURCH DO
2280 E 25TH ST
IDAHO FALLS, ID 83404-7542
Phone number: 208-227-2100
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Mailing Address
ADAM NIELSEN BURCH DO
PO BOX 742358
ATLANTA, GA 30374-2358
Phone number:
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