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General NPI Number Information
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NPI Number | 1609301209
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Entity Type | Individual
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Provider Name | MR. CHARLES RAYMOND BOWMAN
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Gender | Male
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Dates
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Enumeration Date | 04/21/2017
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Last Update Date | 04/21/2017
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Provider Practice Location Address
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Address Line | 830 BOARDMAN CANFIELD RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44512-4213
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Country | US
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Telephone | 330-259-9393
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Fax |
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Provider Business Mailing Address
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Address Line | 3811 BELLWOOD DR SE
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City | WARREN
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State | OH
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Zip | 44484-2940
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Country | US
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Telephone | 330-720-5591
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5212
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License Number State | OH
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