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Mr. Willie Bowman, COOK
Meals Provider in Bossier City, Louisiana
NPI 1710740196

Willie Bowman is a Meals Provider based in Bossier City, LA. Willie Bowman practices in Bossier City, LA and has the professional credentials of COOK. The NPI Number for Willie Bowman is 1710740196 and holds a License No. (Louisiana).

The current practice location address for Willie Bowman is 1525 Fullilove Dr, Bossier City, LA and can be reached out via phone at 318-222-8511.

Location: 1525 Fullilove Dr, Bossier City, LA, 71111-5864
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1710740196
Provider Name
Willie Bowman
Credential
COOK
Provider Entity Type
Individual
Gender
Male
Address
1525 Fullilove Dr, Bossier City, LA, 71111-5864
Phone Number
318-222-8511
Fax Number
Provider Enumeration Date
01/30/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1525 Fullilove Dr
City
Bossier City
State
Louisiana
Zip
71112-3346
Phone Number
318-222-8511
Fax Number
person
Provider Business Mailing Address Details
Address
1525 Fullilove Dr
City
Bossier City
State
Louisiana
Zip
71112-3346
Phone Number
318-222-8511
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Meals
Speciality
-
Taxonomy
174200000X
License No.
(Louisiana)
Definition
A public or privately owned facility providing meals to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
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