Individual
MR. JOHN WESLEY COLLINS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S
Contact information
Practice address
1740 E 17TH ST STE C, IDAHO FALLS, ID 83404-6375
(208) 524-1278
Mailing address
905 STANGER AVE, IDAHO FALLS, ID 83404-5521
(208) 757-2994
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/11/2009
Last updated
08/11/2009
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