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1144190570
ALLEN J FOWLER
IDAHO FALLS, ID
NPI
1144190570
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID 11457)
Enumeration Date
2025-11-10
Last Update Date
2025-11-10
Business Address
ALLEN J FOWLER ADC
1020 LAND BANK ST
IDAHO FALLS, ID 83402-1809
Phone number: 208-520-6992
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Mailing Address
ALLEN J FOWLER ADC
1020 LAND BANK ST
IDAHO FALLS, ID 83402-1809
Phone number: 208-520-6992
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