| Organization Name: | J BOATMAN LLC |
| NPI Number: | 1003112558 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY BOATMAN (OWNER) |
| Mailing Address: | 1201 Bellevue Ave St Louis |
| State: | MO US |
| Postal Code: | 63117 |
| Phone Number: | 3146474788 |
| Fax Number: | 3146476305 |
| NPI Enumeration Date: | 02/01/2011 |
| NPI Last Update Date: | 02/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | 11805 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |