JUSTIN BOUTWELL

BROKEN BOW, NE
NPI1861959017
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: NE  2387)
Enumeration Date2019-02-25
Last Update Date2019-08-19
Business Address
Mr. JUSTIN BOUTWELL PA
145 MEMORIAL DR
BROKEN BOW, NE 68822-1378
Phone number: 308-872-2486
Mailing Address
Mr. JUSTIN BOUTWELL PA
145 MEMORIAL DR
BROKEN BOW, NE 68822-1378
Phone number: 308-991-4571
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