Individual
GLENDA AUDREY SMITH FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
2611 PRINGLE RD SE, SALEM, OR 97302-1533
(503) 385-4709
Mailing address
2611 PRINGLE RD SE, SALEM, OR 97302-1533
(503) 385-4709
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
297154
—
OR
Enumeration date
04/13/2007
Last updated
09/16/2011
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