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1689088593
CLAYDEN PORTER
IDAHO FALLS, ID
NPI
1689088593
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: ID LSW 33236)
Enumeration Date
2014-06-18
Last Update Date
2014-06-18
Business Address
-- CLAYDEN PORTER LSW
540 3RD ST
IDAHO FALLS, ID 83401-3953
Phone number: 208-524-5607
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Mailing Address
-- CLAYDEN PORTER LSW
1090 10TH ST
IDAHO FALLS, ID 83404-5063
Phone number:
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