Individual
DR. BRYAN R BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
401 S WALNUT ST, PINCKNEYVILLE, IL 62274-1344
(618) 357-2020
(618) 357-2100
Mailing address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 997-6250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009730
IL
152W00000X
Optometrist
2001018120
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009730
—
IL
Enumeration date
06/23/2005
Last updated
01/25/2017
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