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NPI Code Detail

MEDICARE: KRISTIN BOWENS

MEDICARE: KRISTIN BOWENS
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
1225X00000XOccupational TherapistBOTOCT00222570KY

General Provider Information

NPI Number : 1740647395
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN BOWENS
Provider Business Mailing Address
First Line : 211 MONTY BEVINS BTM
Second Line :
City : HATFIELD
State : KY
Zip : 41514-8549
Country : US
Telephone Number : 304-953-0633
Fax Number :
Provider Business Practice Location Address
First Line : 250 MCDAVID BLVD
Second Line :
City : GRAYSON
State : KY
Zip : 41143-1603
Country : US
Telephone Number : 606-474-7935
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2016
Last Update Date : 01/26/2016

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