Provider Demographics
NPI:1295860708
Name:BOWER, KAREN I (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:I
Last Name:BOWER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 W FAIRMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:14750-1724
Mailing Address - Country:US
Mailing Address - Phone:716-661-4627
Mailing Address - Fax:716-985-6662
Practice Address - Street 1:3023 ROUTE 430
Practice Address - Street 2:
Practice Address - City:GREENHURST
Practice Address - State:NY
Practice Address - Zip Code:14742
Practice Address - Country:US
Practice Address - Phone:716-661-4627
Practice Address - Fax:716-985-6662
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022566-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist