Individual
ANGELETTE AMANDA LOVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
2327 CORONADO ST, IDAHO FALLS, ID 83404-7407
(208) 528-1000
Mailing address
2343 ANDREW ST, POCATELLO, ID 83201-7913
(801) 928-9819
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-1072
ID
Other
Enumeration date
01/31/2025
Last updated
01/31/2025
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