Organization
FOOTHILLS PSYCHIATRY AND ADDICTION
Active
Organization
FOOTHILLS PSYCHIATRY AND ADDICTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON MARTIN PMHNP-BC (PSYCHIATRIC NURSE PRACTITIONER)
(208) 360-0288
Entity
Organization
Contact information
Practice address
13734 S 1ST E, IDAHO FALLS, ID 83404-7852
(208) 360-0288
Mailing address
13734 S 1ST E, IDAHO FALLS, ID 83404-7852
(208) 360-0288
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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