Individual
JAMES GOWDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3239 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(719) 275-7650
Mailing address
517 N 11TH ST, CANON CITY, CO 81212-3433
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
NLC-12793
CO
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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