Provider Demographics
NPI:1073946471
Name:BOWMAN, CELENA ARLET (PT)
Entity Type:Individual
Prefix:
First Name:CELENA
Middle Name:ARLET
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CELENA
Other - Middle Name:ARLET
Other - Last Name:GREER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:825 DAVIS ST STE B
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-7009
Mailing Address - Country:US
Mailing Address - Phone:540-774-0729
Mailing Address - Fax:540-774-0862
Practice Address - Street 1:4600 BRAMBLETON AVE STE B
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018
Practice Address - Country:US
Practice Address - Phone:540-774-0729
Practice Address - Fax:540-774-0862
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203870225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist