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NPI Code Detail

MEDICARE: SARAH BOWMAN PTA

MEDICARE: SARAH BOWMAN PTA
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
1225200000XPhysical Therapy Assistant1897-19WI

General Provider Information

NPI Number : 1477804177
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH BOWMAN PTA
Provider Business Mailing Address
First Line : 8301 OLD SAUK RD
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-4389
Country : US
Telephone Number : 608-662-8866
Fax Number : 608-827-9667
Provider Business Practice Location Address
First Line : 8301 OLD SAUK RD
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-4389
Country : US
Telephone Number : 608-662-8866
Fax Number : 608-827-9667
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2012
Last Update Date : 09/21/2012

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