CHARLES DOUGLAS BRYAN

BLACKFOOT, ID
NPI1689315111
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ID  LMSW-27872)
Enumeration Date2022-04-06
Last Update Date2022-04-06
Business Address
CHARLES DOUGLAS BRYAN
373 W HIGHWAY 39 STE 1
BLACKFOOT, ID 83221-5228
Phone number: 208-557-9450
Mailing Address
CHARLES DOUGLAS BRYAN
444 HOSPITAL WAY STE 422
POCATELLO, ID 83201-2744
Phone number: 208-557-9450
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