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General NPI Number Information
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NPI Number | 1033803671
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Entity Type | Individual
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Provider Name | BRIANNA LEE BOWLES AU.D.
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Gender | Female
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 1179 FORTUNE BLVD
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City | SHILOH
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State | IL
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Zip | 62269-7377
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Country | US
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Telephone | 618-628-0715
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Fax |
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Provider Business Mailing Address
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Address Line | 8141 COUNTY LINE RD
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City | COLLINSVILLE
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State | IL
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Zip | 62234-6961
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Country | US
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Telephone | 618-803-9181
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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