GARY DALE CONDER

FORT HALL, ID
NPI1538323225
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID  DA116101G)
Enumeration Date2008-07-11
Last Update Date2008-07-11
Business Address
-- GARY DALE CONDER ICADC
115 PIMA DRIVE
FORT HALL, ID 83203-0306
Phone number: 208-238-2400
Mailing Address
-- GARY DALE CONDER ICADC
115 PIMA DRIVE
FORT HALL, ID 83203-0306
Phone number: 208-238-2400
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