Individual
JAMIE BOVIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
51600 HUNTINGTON RD, LA PINE, OR 97739-8887
(541) 536-3435
Mailing address
PO BOX 3300, LA PINE, OR 97739-3300
(541) 536-3435
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
THW000004135
OR
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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