Bret Wixom's National Provider Identifier (NPI) Details
Bret Wixom, lcsw
NPI: 1720171358
Enumeration Date: 2006-10-02
Last updated: 2007-07-09
Sole Proprietor: NO
Status: active
Postal Address: 3422 S 15TH E, IDAHO FALLS, ID
Phone: 208-552-1222
Primary Practice Address: 3422 S 15TH E, IDAHO FALLS, ID
Practice's phone: 208-552-1222