Individual
MADISON JUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
502 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5298
(208) 348-7500
Mailing address
502 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5298
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/25/2024
Last updated
10/25/2024
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