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1861844094
EDWARD MATHEWS
IDAHO FALLS, ID
NPI
1861844094
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID ISAS-10328)
Enumeration Date
2016-07-12
Last Update Date
2016-07-12
Business Address
-- EDWARD MATHEWS ISAS
482 CONSTITUTION WAY SUITE 110
IDAHO FALLS, ID 83402-3565
Phone number: 208-932-4493
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Mailing Address
-- EDWARD MATHEWS ISAS
482 CONSTITUTION WAY SUITE 110
IDAHO FALLS, ID 83402-3565
Phone number: 208-932-4493
Copy
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