Healthcare Provider Details

I. General information

NPI: 1508791609
Provider Name (Legal Business Name): ASHLYN BOWER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1649 E PINE AVE
MERIDIAN ID
83642-8135
US

IV. Provider business mailing address

1350 N WEBB WAY APT 0-307
MERIDIAN ID
83642-1171
US

V. Phone/Fax

Practice location:
  • Phone: 208-917-2660
  • Fax: 208-917-2630
Mailing address:
  • Phone: 307-250-0608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8481016
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: