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1750161980
RIVERSIDE WELLNESS, LLC
BLACKFOOT, ID
NPI
1750161980
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Entity Type
Organization
Authorized Contact
ASHTON W HOLBROOK
Owner
208-417-9638
Organization Subpart ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2023-10-04
Last Update Date
2023-10-04
Business Address
RIVERSIDE WELLNESS, LLC
167 N 710 W
BLACKFOOT, ID 83221-5380
Phone number: 208-417-9638
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Mailing Address
RIVERSIDE WELLNESS, LLC
167 N 710 W
BLACKFOOT, ID 83221-5380
Phone number: 208-417-9638
Copy
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