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Individual

DEREK COWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDMT

Contact information

Practice address
505 RIMKUS DRIVE, SCOTT AIR FORCE BASE, IL 62225
(940) 636-2753
Mailing address
505 RIMKUS DRIVE, SCOTT AIR FORCE BASE, IL 62225
(940) 636-2753

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
07/27/2009
Last updated
07/27/2009
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