MR. Brent Stanley Packer, BS

NPI #1255677076 in Blackfoot, Idaho

Provider Information

NPI Number: 1255677076
Entity Type: Individual
Name: MR. Brent Stanley Packer, BS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: BS
Enumeration Date: Dec 26, 2012
Last Updated: Dec 26, 2012

Practice Location

Address: 1190 YORK DR
City: Blackfoot
State: Idaho
ZIP Code: 83221-3621
Phone: (208) 201-0144

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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