CODY ALLEN BURGESS
Individual Provider (NPI-1)
Active
Peer Specialist
Provider Information
- NPI Number
1245174713- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 495 N SHILLING AVE APT 1, BLACKFOOT, ID, 832212336
- Phone
- (208) 643-4433
Specialties & Taxonomies
Peer Specialist
Primary License: ID