Most Relevant Information
Provider Data
NPI Number: | 1003579657 |
Provider Name: | TYLER BOWMAN |
Entity Type: | Individual |
Taxonomy Code: | 324500000X |
Specialty: | Substance Abuse Rehabilitation Facility |
License Number: |
Most Important Dates
Enumeration Date: | 10/20/2021 |
Last Updated: | 10/20/2021 |
Provider Practice Location
1445 DONLON ST STE 15
VENTURA
CA
930035640
Practice Location Phone/Fax
Phone: | 8058502686 |
Fax: |
Provider Mailing Location
2759 SAILOR AVE
VENTURA
CA
930014159
Provider Mailing Phone/Fax
Phone: | |
Fax: |