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General NPI Number Information
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NPI Number | 1467319889
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Entity Type | Individual
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Provider Name | WILLIAM BOZEMAN DHSC
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Gender | Male
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 4140 E BASELINE RD STE 101
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City | MESA
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State | AZ
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Zip | 85206-4413
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Country | US
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Telephone | 505-870-4949
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Fax | 877-285-0477
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Provider Business Mailing Address
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Address Line | 4140 E BASELINE RD STE 101
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City | MESA
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State | AZ
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Zip | 85206-4413
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Country | US
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Telephone | 505-870-4949
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Fax | 877-285-0477
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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