Individual
GRETTA COZETTE OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2277 E LINCOLN RD, IDAHO FALLS, ID 83401-2202
(208) 701-1800
Mailing address
246 N CURLEW DR APT 2202, AMMON, ID 83401-1432
(865) 256-5798
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2971267
ID
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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