Healthcare Provider Details

I. General information

NPI: 1265292924
Provider Name (Legal Business Name): JOSHUA SETH BOWMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 N 4TH ST
MONTPELIER ID
83254-1225
US

IV. Provider business mailing address

277 N 4TH ST
MONTPELIER ID
83254-1225
US

V. Phone/Fax

Practice location:
  • Phone: 208-425-4333
  • Fax:
Mailing address:
  • Phone: 208-425-4333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIA-2398
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: