Provider Demographics
NPI:1235476409
Name:BOWER, ALYSIA JEAN
Entity Type:Individual
Prefix:MS
First Name:ALYSIA
Middle Name:JEAN
Last Name:BOWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 S CARSON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-5262
Mailing Address - Country:US
Mailing Address - Phone:775-461-0551
Mailing Address - Fax:
Practice Address - Street 1:701 S CARSON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-5262
Practice Address - Country:US
Practice Address - Phone:775-461-0551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner