Individual
CONNOR BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3200 EAGLE PARK DR NE STE 102, GRAND RAPIDS, MI 49525-7057
(616) 285-9090
Mailing address
1258 SHERMAN ST SE, GRAND RAPIDS, MI 49506-2612
(616) 915-7467
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008994
MI
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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