Individual
BODEN JAMES PORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6900 ALDEN DR BLDG 160, FE WARREN AFB, WY 82005-2945
(307) 773-3039
Mailing address
6900 ALDEN DR BLDG 160, FE WARREN AFB, WY 82005-2945
(307) 773-3039
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
02008108A
IN
Other
Enumeration date
03/22/2023
Last updated
04/21/2025
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