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1851551873
JEREMY CLARK
POCATELLO, ID
NPI
1851551873
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2008-06-12
Last Update Date
2008-06-12
Business Address
JEREMY CLARK
2055 GARRETT WAY STE 1
POCATELLO, ID 83201-5100
Phone number: 208-236-1600
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Mailing Address
JEREMY CLARK
2055 GARRETT WAY STE 1
POCATELLO, ID 83201-5100
Phone number: 208-236-1600
Copy
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