Provider Demographics
NPI:1235638776
Name:SOWERS, DAMON
Entity Type:Individual
Prefix:
First Name:DAMON
Middle Name:
Last Name:SOWERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1852 PATRICIA DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6755
Mailing Address - Country:US
Mailing Address - Phone:931-801-5012
Mailing Address - Fax:
Practice Address - Street 1:1852 PATRICIA DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6755
Practice Address - Country:US
Practice Address - Phone:931-801-5012
Practice Address - Fax:931-801-5012
Is Sole Proprietor?:No
Enumeration Date:2018-02-11
Last Update Date:2018-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer