Individual
BRENT LEGRAND BOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2825 E MALL DRIVE, ST. GEORGE, UT 84790
(801) 354-8225
Mailing address
1055 N 500 W, PROVO, UT 84604-3305
(801) 354-8225
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
—
—
363A00000X
Physician Assistant
Primary
12118236-1206
UT
Other
Enumeration date
02/27/2013
Last updated
02/12/2021
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