Charles Douglas Bryan

NPI #1689315111 in Blackfoot, Idaho

Provider Information

NPI Number
1689315111
Entity Type
Individual
Name
Charles Douglas Bryan
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Social Worker - Clinical
Enumeration Date
Apr 6, 2022
Last Updated
Apr 6, 2022

Practice Location

Address
373 W HIGHWAY 39 STE 1
State
Idaho
ZIP Code
83221-5228
Phone
(208) 557-9450

Specialties & Taxonomy Codes

Specialty
Social Worker - ClinicalClinical

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