Provider Demographics
NPI:1073916722
Name:BOWMAN, JANICE ELAINE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:ELAINE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31645 WINNERS CIR
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-4032
Mailing Address - Country:US
Mailing Address - Phone:216-920-1108
Mailing Address - Fax:
Practice Address - Street 1:1470 WARREN RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-3918
Practice Address - Country:US
Practice Address - Phone:216-529-4000
Practice Address - Fax:216-228-8327
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT010797225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist