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General NPI Number Information
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NPI Number | 1447015532
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Entity Type | Individual
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Provider Name | NICHOLAS BOWERS
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Gender | Male
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Dates
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Enumeration Date | 02/16/2024
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 7999 PHILIPS HWY STE 305
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City | JACKSONVILLE
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State | FL
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Zip | 32256-4404
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Country | US
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Telephone | 904-257-1720
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Fax |
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Provider Business Mailing Address
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Address Line | 12381 SEA ISLAND DR
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City | JACKSONVILLE
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State | FL
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Zip | 32225-5374
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Country | US
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Telephone |
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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 | 33315
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License Number State | FL
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