Healthcare Provider Details

I. General information

NPI: 1780521807
Provider Name (Legal Business Name): LYNETTE BOWEN M ED, CRP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 CREEK ST UNIT D
WRENTHAM MA
02093-1478
US

IV. Provider business mailing address

299 CREEK ST UNIT D
WRENTHAM MA
02093-1478
US

V. Phone/Fax

Practice location:
  • Phone: 508-954-8432
  • Fax:
Mailing address:
  • Phone: 508-954-8432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: