Individual
KELLY EILEEN BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19420 N 59TH AVE STE H830, GLENDALE, AZ 85308-6980
(623) 302-9020
Mailing address
12409 W PALO VERDE DR, LITCHFIELD PARK, AZ 85340-3801
(480) 274-5264
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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