Individual
AMANDA BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1408 POMERELLE AVE STE H, BURLEY, ID 83318-2068
(208) 677-6170
Mailing address
2410 DORCHESTER AVE, BURLEY, ID 83318-2526
(208) 312-3207
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/13/2026
Last updated
05/13/2026
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