Individual provider · NPI-1

Jim Boman

Technician/Technologist, Ophthalmic · Philadelphia, PA

NPI number1407628688
StatusActive
Last updated in NPPESMar 23, 2025

Details

NPI
1407628688
Entity type
Individual (NPI-1)
Name
Jim Boman
Sex
Male
Sole proprietor
No
Enumeration date
Oct 23, 2023
Certification date
Mar 23, 2025
Last updated
Mar 23, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1100X Technician/Technologist, Ophthalmic––Yes

Practice location

3200 Red Lion Rd
Philadelphia, PA 19114-1129

Phone 215-632-7378

Mailing address

3200 Red Lion Rd
Philadelphia, PA 19114-1129

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