JACOB THOMAS VIDA

SALEM, OR
NPI1164996278
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2019-01-11
Last Update Date2019-01-11
Business Address
JACOB THOMAS VIDA
3321 HAROLD DR NE
SALEM, OR 97305-1339
Phone number: 503-399-5597
Mailing Address
JACOB THOMAS VIDA
250 CHURCH ST SE STE 202
SALEM, OR 97301-3921
Phone number: 503-385-8395
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