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General NPI Number Information
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NPI Number | 1629710249
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Entity Type | Individual
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Provider Name | SARAH BOWMAN ATC
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Gender | Female
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 425 JACK BRANCH DRIVE
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City | BOONE
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State | NC
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Zip | 28608-0001
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Country | US
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Telephone | 704-472-5172
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Fax |
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Provider Business Mailing Address
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Address Line | 331 W 27TH ST
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City | BALTIMORE
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State | MD
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Zip | 21211-3004
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Country | US
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Telephone | 336-516-4495
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | A01394
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License Number State | MD
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