Provider Demographics
NPI:1346313954
Name:BOWER, HEIDI J (AT,C)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:J
Last Name:BOWER
Suffix:
Gender:F
Credentials:AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 HARRISONVILLE RD # B
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-3303
Mailing Address - Country:US
Mailing Address - Phone:856-935-3900
Mailing Address - Fax:
Practice Address - Street 1:219 WALNUT ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079-9443
Practice Address - Country:US
Practice Address - Phone:856-935-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer