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
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