Individual provider · NPI-1

Johnny Bowman III

Home Health Aide · Winston Salem, NC

NPI number1811303571
StatusActive
Last updated in NPPESJul 2, 2014

Details

NPI
1811303571
Entity type
Individual (NPI-1)
Name
Johnny Bowman III
Sex
Male
Sole proprietor
No
Enumeration date
Jul 2, 2014
Last updated
Jul 2, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
374U00000X Home Health Aide––Yes

Practice location

7104 Brandemere Ln Apt A
Winston Salem, NC 27106-6445

Phone 336-577-3831

Mailing address

7104 Brandemere Ln Apt A
Winston Salem, NC 27106-6445

Phone 336-577-3831

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