Individual
LUKE GEROSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
921 S ORCHARD ST STE G, BOISE, ID 83705-1992
(888) 392-8642
Mailing address
4090 N AMBERCREEK AVE, MERIDIAN, ID 83646-7021
(208) 761-4305
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/11/2023
Last updated
01/11/2023
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