MR. Justin Boutwell, PA
NPI #1861959017 in Broken Bow, Nebraska
Provider Information
- NPI Number
- 1861959017
- Entity Type
- Individual
- Name
- MR. Justin Boutwell, PA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Medical
- Credential
- PA
- Enumeration Date
- Feb 25, 2019
- Last Updated
- Aug 19, 2019
Practice Location
- Address
- 145 MEMORIAL DR
- City
- Broken Bow
- State
- Nebraska
- ZIP Code
- 68822-1378
- Phone
- (308) 872-2486
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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