Individual
BRENT W BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
130 MILL RD, HORSESHOE BEND, ID 83629-5103
(208) 793-3115
(208) 793-3321
Mailing address
130 MILL RD, HORSESHOE BEND, ID 83629-5103
(208) 793-3115
(208) 793-3321
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
H-256
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AU555
BLUE CROSS OF IDAHO
ID
Enumeration date
02/04/2007
Last updated
07/08/2007
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