Provider Demographics
NPI:1134476906
Name:BOWIE, LORI DYHRBERG (OTR)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:DYHRBERG
Last Name:BOWIE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15052 WESTERN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-1911
Mailing Address - Country:US
Mailing Address - Phone:248-245-0535
Mailing Address - Fax:
Practice Address - Street 1:11941 BELSAY RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1702
Practice Address - Country:US
Practice Address - Phone:810-694-1970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002232225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation