Individual
BOWMAN J BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
35 S 400 W, OREM, UT 84058-5324
(801) 800-2550
(801) 705-4040
Mailing address
35 S 400 W, OREM, UT 84058-5324
(801) 800-2550
(801) 705-4040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10709846-4405
UT
Other
Enumeration date
09/16/2022
Last updated
06/23/2025
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