Individual
MR. GREG LOVELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
283 WEST 19TH STREET, IDAHO FALLS, ID 83402
(208) 524-6347
Mailing address
283 WEST 19TH STREET, IDAHO FALLS, ID 83402
(208) 524-6347
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW-31597
ID
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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