Individual
MR. WILLIE BOWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COOK
Contact information
Practice address
1525 FULLILOVE DR, BOSSIER CITY, LA 71112-3346
(318) 222-8511
Mailing address
2601 AIRLINE DR APT 912, BOSSIER CITY, LA 71111-5864
(318) 840-3560
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
—
LA
Other
Enumeration date
01/30/2024
Last updated
01/30/2024
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