Individual
ROBERT DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
890 N COLE RD, STE B, BOISE, ID 83704-8614
(208) 322-1026
(208) 322-1029
Mailing address
890 N COLE RD, STE B, BOISE, ID 83704-8614
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-33570
ID
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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