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Individual

PAUL BRYAN WURTSMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3754 BRIAR CREEK LN, AMMON, ID 83406-4688
(360) 831-7425
Mailing address
3754 BRIAR CREEK LN, AMMON, ID 83406-4688
(360) 831-7425

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-37202
ID

Other

Enumeration date
02/27/2018
Last updated
02/27/2018
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