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NPI Code Detail

MEDICARE: LISA MARIE BOWERS

MEDICARE:   LISA MARIE BOWERS
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
1224P00000XProsthetist

General Provider Information

NPI Number : 1528620101
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE BOWERS
Provider Business Mailing Address
First Line : 3330 E WAHALLA LN
Second Line :
City : PHOENIX
State : AZ
Zip : 85050-7904
Country : US
Telephone Number : 602-568-8506
Fax Number :
Provider Business Practice Location Address
First Line : 3330 E WAHALLA LN
Second Line :
City : PHOENIX
State : AZ
Zip : 85050-7904
Country : US
Telephone Number : 602-568-8506
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2019
Last Update Date : 07/03/2019

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Directions to “ LISA MARIE BOWERS ” Practice Location

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