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General NPI Number Information
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NPI Number | 1649209362
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Entity Type | Organization
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Legal Business Name | BOWYER PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 100 YMCA LN
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City | SEBRING
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State | FL
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Zip | 33875-4352
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Country | US
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Telephone | 863-382-2949
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Fax |
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Provider Business Mailing Address
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Address Line | 100 YMCA LN
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City | SEBRING
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State | FL
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Zip | 33875-4352
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Country | US
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Telephone | 863-382-2949
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KEITH ANTHONY BOWYER JR.
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Credential | PT
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Telephone | 863-382-2949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT16172
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License Number State | FL
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