MEDICARE: BOWDEN INJURY & REHABILITATION

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
1	225100000X	Physical Therapist
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1831631829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOWDEN INJURY & REHABILITATION

Provider Business Mailing Address
First Line	:	1417 MONROE AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38104-3634
Country	:	US
Telephone Number	:	901-272-7200
Fax Number	:	901-272-0820

Provider Business Practice Location Address
First Line	:	1215 POPLAR AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38104-7241
Country	:	US
Telephone Number	:	901-472-4190
Fax Number	:	901-443-0375

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	MRS. SEANDRIA E ECHOLS COBBINS
Credential	:
Telephone Number	:	901-272-7200

Provider Enumeration Date	:	11/08/2016
Last Update Date	:	09/22/2017

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