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General NPI Number Information
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NPI Number | 1588891246
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Entity Type | Individual
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Provider Name | JAN J BOWMAN M.ED., CTRS
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Gender | Female
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Dates
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Enumeration Date | 06/19/2009
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Last Update Date | 06/19/2009
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Provider Practice Location Address
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Address Line | 2200 FORT ROOTS DR
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-1709
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Country | US
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Telephone | 501-257-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 N HARRISON ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-1824
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Country | US
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Telephone | 501-296-9109
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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 | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number |
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License Number State |
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