Kirk Lynn Mace MSW

NPI 1134242712 - Social Worker - 104100000X

NPI Details
NPI 1134242712
Gender Male
Enumeration Date 04/09/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
218 DIVIDEND DR STE 3
REXBURG ID, 83440-3510, US
Phone (208) 359-9683
Fax (208) 359-9683
Business Location
679 W STONEBRIDGE
REXBURG ID, 83440-5193, US
Phone (208) 656-0409
Fax
Toxanomy
Taxonomy Code 104100000X
License State Idaho
License Number LSW-2660
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According to our database, Mr. Kirk Lynn Mace MSW NPI is 1134242712, taxonomy code is 104100000X and license number is LSW-2660, license state is located at Idaho. Kirk Lynn Mace MSW physically located at 218 Dividend Dr Ste 3, Rexburg ID, 83440-3510. NPI Number Kirk Lynn Mace MSW has the Individual type.

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1134242712 NPI number is provided on an as is basis without warranty of any kind. 1134242712 is maintained by the National Plan & Provider Enumeration System. The contents of Kirk Lynn Mace MSW are for informational purposes only.