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General NPI Number Information
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NPI Number | 1710186937
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Entity Type | Individual
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Provider Name | GERARD ANTHONY BOZMAN DC
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Gender | Male
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 8050 DEAN MARTIN
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City | LAS VEGAS
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State | NV
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Zip | 89139
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Country | US
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Telephone | 702-269-1540
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Fax | 702-269-9215
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Provider Business Mailing Address
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Address Line | 10956 SANTORINI DR
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City | LAS VEGAS
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State | NV
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Zip | 89141
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Country | US
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Telephone | 702-269-1540
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Fax | 702-269-9215
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | B01024
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License Number State | NV
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