Loose Cannon Social Work, Llc.

NPI #1811447725 in Saint George, Utah

Provider Information

NPI Number
1811447725
Entity Type
Organization
Organization Name
Loose Cannon Social Work, Llc.
Primary Specialty
Exclusive Provider Organization
Enumeration Date
Oct 4, 2016
Last Updated
Oct 4, 2016

Practice Location

Address
2298 E 200 S
State
Utah
ZIP Code
84790-1603
Phone
(801) 652-4437

Authorized Official

Name
MR. BRUCE CRAIG SOLOMON, LCSW
Title
MANAGER
Phone
(801) 652-4437

Specialties & Taxonomy Codes

Specialty
Exclusive Provider Organization

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