MEDICARE: ANDREA L BOWMAN MAC.OM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	0698	AZ

General Provider Information

NPI Number	:	1538488523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA L BOWMAN MAC.OM

Provider Business Mailing Address
First Line	:	2601 S SARNOFF DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85730-1206
Country	:	US
Telephone Number	:	520-261-5862
Fax Number	:

Provider Business Practice Location Address
First Line	:	7225 N MONA LISA RD STE 100A
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-4528
Country	:	US
Telephone Number	:	520-261-5862
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2010
Last Update Date	:	05/31/2010

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