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Individual

ADAM SPENCER BOMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
90 E 200 N, LOGAN, UT 84321-4034
(435) 752-0750
(435) 752-7433
Mailing address
90 E 200 N, LOGAN, UT 84321-4034
(435) 752-0750
(435) 752-7433

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1026
UT
Enumeration date
11/11/2010
Last updated
11/11/2010
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