Individual
MR. JONATHAN HALL BOSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
(417) 831-0155
Mailing address
PO BOX 5681, SPRINGFIELD, MO 65801-5681
(417) 831-0150
(417) 831-0155
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2005002880
MO
Other
Enumeration date
08/25/2006
Last updated
03/30/2011
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