Bryan, Charles Douglas
Bryan, Charles Douglas is an individual health care provider with primary practice located at 373 W Highway 39 Ste 1 , Blackfoot ID 83221-5228. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bryan, Charles Douglas can be contacted via phone (208) 557-9450.Contact Information
Primary practice address
373 W Highway 39 Ste 1
Blackfoot ID 83221-5228
Phone: (208) 557-9450
Fax: (208) 561-7111
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LMSW-27872 | Idaho |
Profile Details
| NPI number | 1689315111 |
|---|---|
| LBN Legal business name | Bryan, Charles Douglas |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 6th, 2022 |
| Last updated | Apr 6th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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