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General NPI Number Information
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NPI Number | 1104902113
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Entity Type | Individual
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Provider Name | JESSICA E BOWER DPT
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 3942 DAVIS STUART RD STE 3
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City | RONCEVERTE
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State | WV
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Zip | 24970-0269
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Country | US
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Telephone | 304-647-3987
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Fax | 304-647-3990
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Provider Business Mailing Address
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Address Line | 3942 DAVIS STUART RD STE 3
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City | RONCEVERTE
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State | WV
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Zip | 24970-0269
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Country | US
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Telephone | 304-647-3987
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Fax | 304-647-3990
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 2537
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP011718T
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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