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General NPI Number Information
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NPI Number | 1205100708
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Entity Type | Individual
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Provider Name | JOSHUA KEITH SOWDERS PTA
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Gender | Male
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 2000 REGENCY MANOR CIR
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City | COLUMBUS
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State | OH
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Zip | 43207-1777
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Country | US
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Telephone | 614-445-8261
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Fax |
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Provider Business Mailing Address
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Address Line | 7675 OAK HILL RD NE
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City | BREMEN
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State | OH
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Zip | 43107-9711
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Country | US
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Telephone | 740-304-2772
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 7644
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License Number State | OH
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