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1023444957
JORGE PADRON
IDAHO FALLS, ID
NPI
1023444957
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID 155)
Enumeration Date
2013-09-24
Last Update Date
2013-09-24
Business Address
Mr. JORGE PADRON CADC
543 3RD ST
IDAHO FALLS, ID 83401-3909
Phone number: 208-522-6925
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Mailing Address
Mr. JORGE PADRON CADC
550 AMY LN
AMMON, ID 83406-4542
Phone number: 208-589-4139
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