Individual
AMANDA JODI ROWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LD, RDA
Contact information
Practice address
10480 W GARVERDALE CT STE 804A, BOISE, ID 83704-5477
(208) 376-6613
Mailing address
1105 N 5TH ST, COEUR D ALENE, ID 83814-3221
(480) 289-0536
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
99
ID
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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