Individual
DUSTIN K BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-2711
Mailing address
190 E BANNOCK ST., BOISE, ID 83712
(208) 381-2711
(208) 381-4675
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA523
ID
Other
Enumeration date
06/21/2006
Last updated
08/04/2011
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