Individual
CHARLES EDWARD BOWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1518 LIATRIS LN, NORTH POLE, AK 99705-5082
(907) 687-3940
Mailing address
1513 LIATRIS LN, NORTH POLE, AK 99705-5082
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
514661
—
AK
Enumeration date
06/18/2020
Last updated
06/18/2020
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