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1386018950
CODY FOWLER
IDAHO FALLS, ID
NPI
1386018950
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: ID PA-1326)
Enumeration Date
2015-11-19
Last Update Date
2022-02-08
Business Address
-- CODY FOWLER P.A.-C
3345 POTOMAC WAY
IDAHO FALLS, ID 83404-4978
Phone number: 208-552-7572
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Mailing Address
-- CODY FOWLER P.A.-C
PO BOX 277381
ATLANTA, GA 30384-7381
Phone number:
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