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General NPI Number Information
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NPI Number | 1588813604
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Entity Type | Individual
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Provider Name | MARY BOWMAN-CLINE CMT
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Gender | Female
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Dates
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Enumeration Date | 09/12/2008
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Last Update Date | 09/12/2008
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Provider Practice Location Address
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Address Line | 514 SAINT PETER ST SUITE 280
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City | SAINT PAUL
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State | MN
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Zip | 55102-1001
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Country | US
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Telephone | 763-442-1340
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Fax |
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Provider Business Mailing Address
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Address Line | 2855 GRAND ST NE
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City | MINNEAPOLIS
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State | MN
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Zip | 55418-2613
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Country | US
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Telephone | 763-442-1340
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 20080002107
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License Number State | MN
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