Individual
MR. JERALD DOUGLAS BOZEMAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
750 N SOCORA, WICHITA, KS 67212
(316) 462-2273
(316) 462-2276
Mailing address
6405 W CLEAR MEADOW ST, WICHITA, KS 67205-2413
(316) 201-4631
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-032675
KS
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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