Healthcare Provider Details

I. General information

NPI: 1235085374
Provider Name (Legal Business Name): BRANDON BOWERS OTD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 W MORRIS BLVD STE B
MORRISTOWN TN
37813-2237
US

IV. Provider business mailing address

325 W MORRIS BLVD STE B
MORRISTOWN TN
37813-2237
US

V. Phone/Fax

Practice location:
  • Phone: 423-375-8907
  • Fax: 423-822-5514
Mailing address:
  • Phone: 423-375-8907
  • Fax: 423-822-5514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number8440
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: