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NPI Code Detail

MEDICARE: MRS. HOLLY LYNN BOWMAN MPT

MEDICARE: MRS. HOLLY LYNN BOWMAN MPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist10632OH

General Provider Information

NPI Number : 1063615607
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HOLLY LYNN BOWMAN MPT
Provider Business Mailing Address
First Line : 301 CHATEAUGAY DR
Second Line :
City : PATASKALA
State : OH
Zip : 43062-7417
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1151 COLLEGE AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43209-2827
Country : US
Telephone Number : 614-559-0270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2007
Last Update Date : 07/08/2007

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