Healthcare Provider Details

I. General information

NPI: 1649694985
Provider Name (Legal Business Name): MR. STEVEN BOWEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 N 10TH ST
NEBRASKA CITY NE
68410-1236
US

IV. Provider business mailing address

117 APRIL AVE
STEPHENS CITY VA
22655
US

V. Phone/Fax

Practice location:
  • Phone: 402-873-3304
  • Fax:
Mailing address:
  • Phone: 402-889-0816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119010019
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: