Individual
JENNIFER BOWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
263 INDIAN CREEK RD, HAILEY, ID 83333-8493
(208) 309-0379
Mailing address
PO BOX 971, HAILEY, ID 83333-0901
(208) 309-0379
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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