Riverside Wellness, Llc | |
167 N 710 W Blackfoot ID 83221-5380 | |
(208) 417-9638 | |
Not Available |
Full Name | Riverside Wellness, Llc |
---|---|
Speciality | Social Worker - Clinical |
Location | 167 N 710 W, Blackfoot, Idaho |
Authorized Official Name and Position | Ashton W Holbrook (OWNER) |
Authorized Official Contact | 2084179638 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Riverside Wellness, Llc 167 N 710 W Blackfoot ID 83221-5380 Ph: (208) 417-9638 | Riverside Wellness, Llc 167 N 710 W Blackfoot ID 83221-5380 Ph: (208) 417-9638 |
NPI Number | 1750161980 |
---|---|
Provider Enumeration Date | 10/04/2023 |
Last Update Date | 10/04/2023 |
Certification Date | 10/04/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750161980 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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