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: |