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NPI Code Detail

MEDICARE: SCOTTY BOWMAN

MEDICARE: SCOTTY BOWMAN
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
1225400000XRehabilitation PractitionerCA

General Provider Information

NPI Number : 1538533351
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTTY BOWMAN
Provider Business Mailing Address
First Line : 440 ARROWOOD DR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95407-7503
Country : US
Telephone Number : 707-565-3495
Fax Number :
Provider Business Practice Location Address
First Line : 440 ARROWOOD DR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95407-7503
Country : US
Telephone Number : 707-565-3495
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2015
Last Update Date : 12/22/2025

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Directions to “ SCOTTY BOWMAN ” Practice Location

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