Healthcare Provider Details

I. General information

NPI: 1245610930
Provider Name (Legal Business Name): FORREST-ANNE BOWMAN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2015
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2077 ONEAL LN
BATON ROUGE LA
70816-3204
US

IV. Provider business mailing address

800 MONROVIA STREET
SHREVEPORT LA
71106
US

V. Phone/Fax

Practice location:
  • Phone: 225-754-5188
  • Fax: 225-754-5189
Mailing address:
  • Phone: 318-655-5961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number61112
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number09607R
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number09607R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: