Healthcare Provider Details

I. General information

NPI: 1669395679
Provider Name (Legal Business Name): COLBY W BOWLES DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 SUNSHINE DR
RICHMOND MO
64085-2607
US

IV. Provider business mailing address

604 SUNSHINE DR
RICHMOND MO
64085-2607
US

V. Phone/Fax

Practice location:
  • Phone: 816-517-2438
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2019029989
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: