Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | PENDING | MO |
NPI | 1093476863 |
---|---|
Provider Name | Drew T Bowers |
First Address | Springfield, MO 65808-9007 |
Second Address | Springfield, MO 65807-5210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2022 |
Last Update Date | 06/01/2022 |