Provider Demographics
NPI:1073800306
Name:BOWER, KARL R (LAC)
Entity Type:Individual
Prefix:MR
First Name:KARL
Middle Name:R
Last Name:BOWER
Suffix:
Gender:M
Credentials:LAC
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Mailing Address - Street 1:316 WASHINGTON ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-4955
Mailing Address - Country:US
Mailing Address - Phone:781-898-4083
Mailing Address - Fax:781-489-3423
Practice Address - Street 1:316 WASHINGTON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-4955
Practice Address - Country:US
Practice Address - Phone:781-898-4083
Practice Address - Fax:781-489-3423
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY004510171100000X
MA254238171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist