JEREMY CLARK

POCATELLO, ID
NPI1851551873
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor Mental Health
Enumeration Date2008-06-12
Last Update Date2008-06-12
Business Address
JEREMY CLARK
2055 GARRETT WAY STE 1
POCATELLO, ID 83201-5100
Phone number: 208-236-1600
Mailing Address
JEREMY CLARK
2055 GARRETT WAY STE 1
POCATELLO, ID 83201-5100
Phone number: 208-236-1600