Individual
CHARLES RAY BOWMAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AIDE
Contact information
Practice address
4301 LISA LN, MIDDLETOWN, OH 45042-2838
(513) 594-7940
Mailing address
4301 LISA LN, MIDDLETOWN, OH 45042-2838
(513) 594-7940
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN128898IV
OH
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2583422
—
OH
Enumeration date
01/27/2007
Last updated
01/13/2008
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