Individual
MR. JORGE PADRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
543 3RD ST, IDAHO FALLS, ID 83401-3909
(208) 522-6925
(208) 522-6934
Mailing address
550 AMY LN, AMMON, ID 83406-4542
(208) 589-4139
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
155
ID
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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