Individual
MR. MATTHEW ALLEN BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S.
Contact information
Practice address
1740 E 17TH ST, SUITE C, IDAHO FALLS, ID 83404-6375
(208) 524-1278
Mailing address
491 W 3RD N, RIGBY, ID 83442-5073
(208) 569-3820
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Enumeration date
03/19/2010
Last updated
03/19/2010
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