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Individual

BRYCE C JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1248 E 17TH ST, IDAHO FALLS, ID 83404-6147
(208) 542-1026
Mailing address
3900 E IONA RD, IDAHO FALLS, ID 83401-5000
(208) 520-2713

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
01/19/2021
Last updated
01/19/2021
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