Provider Demographics
NPI:1326467135
Name:BOWERS, JULIE (LMT)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:BOWERS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 S SAGINAW ST
Mailing Address - Street 2:PO BOX 392
Mailing Address - City:BYRON
Mailing Address - State:MI
Mailing Address - Zip Code:48418-9571
Mailing Address - Country:US
Mailing Address - Phone:810-429-3402
Mailing Address - Fax:
Practice Address - Street 1:122 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:MI
Practice Address - Zip Code:48418-9571
Practice Address - Country:US
Practice Address - Phone:810-429-3402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501001156225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7501001156OtherSTATE OF MICHIGAN