| Doctor Name: | LISA BOWELL |
| NPI Number: | 1164796272 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARRT(R)(N), CNMT |
| License Number: | RRT 04403 |
| Business Practice Address: | 1640 W. Redstone Center Dr. Suite 200 Supplemental Health Care Park City, UT - 840987607 |
| Business Phone Number: | 8888008744 |
| Business Fax Number: | |
| Mailing Address: | 2805 Floral Blvd, BUTTE |
| State: | MT |
| Postal Code: | 597014117 |
| Phone Number: | 4064944169 |
| Fax Number: | |
| NPI Enumeration Date: | 03/07/2012 |
| NPI Last Update Date: | 03/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 247100000X |
| License Number: | RRT 04403 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |