Individual
AMANDA NICOLE BOSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1311 E REPUBLIC RD STE A, SPRINGFIELD, MO 65804-7204
(417) 720-3670
Mailing address
1311 E REPUBLIC RD STE A, SPRINGFIELD, MO 65804-7204
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2021044975
MO
Other
Enumeration date
07/19/2022
Last updated
07/19/2022
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