Basic Information
Provider Information
NPI: 1932301538
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOWERS
FirstName: JULIE
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10604 SCOTNEY AVE NW
Address2:  
City: UNIONTOWN
State: OH
PostalCode: 446859406
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 7233 WHIPPLE AVE NW
Address2:  
City: NORTH CANTON
State: OH
PostalCode: 447207137
CountryCode: US
TelephoneNumber: 3304988200
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/05/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT005722OHY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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