Provider Demographics
NPI:1245587435
Name:BOWSER, KATIE E (DPT)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:E
Last Name:BOWSER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:E
Other - Last Name:WINNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1030 BROADVIEW BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:BRACKENRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15014-1176
Mailing Address - Country:US
Mailing Address - Phone:412-661-5500
Mailing Address - Fax:412-661-4760
Practice Address - Street 1:1030 BROADVIEW BLVD STE 1
Practice Address - Street 2:
Practice Address - City:BRACKENRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15014
Practice Address - Country:US
Practice Address - Phone:412-661-5500
Practice Address - Fax:412-661-4760
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022037225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1027717910001Medicaid
PAP01126953OtherMEDICARE RAILROAD CG7782
PA002723257OtherHIGHMARK BLUE CROSS BLUE SHIELD
PA12431257OtherCAQH
PA246473NJTOtherMEDICARE PTAN