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Individual

MICHAEL SHANE BOWLING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BOCO, BOCP

Contact information

Practice address
5412 DIJON DR, BATON ROUGE, LA 70808-4315
(225) 615-8693
(888) 544-6008
Mailing address
631 COUNTY ROAD 837, BOAZ, AL 35957-8154
(256) 619-1389

Taxonomy

Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
C46945
AL

Other

Enumeration date
03/04/2022
Last updated
03/03/2023
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