Individual
RODNEY BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(434) 738-8586
Mailing address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(434) 738-8586
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004458
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110004458
VA LICENSE
VA
Enumeration date
01/02/2014
Last updated
01/02/2014
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