MEDICARE: JENNY ANN BOWIN

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	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1952679813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNY ANN BOWIN

Provider Business Mailing Address
First Line	:	25140 S 4TH ST
Second Line	:
City	:	OSAGE CITY
State	:	KS
Zip	:	66523-8535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25140 S 4TH ST
Second Line	:
City	:	OSAGE CITY
State	:	KS
Zip	:	66523-8535
Country	:	US
Telephone Number	:	785-249-0916
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2011
Last Update Date	:	12/07/2011

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Directions to “ JENNY ANN BOWIN ” Practice Location

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