Provider Demographics
NPI:1366633125
Name:BOWERS, VANESSA LYNN
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:LYNN
Last Name:BOWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 FAIRLANE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-9567
Mailing Address - Country:US
Mailing Address - Phone:610-779-4896
Mailing Address - Fax:610-370-5201
Practice Address - Street 1:11 FAIRLANE RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-9567
Practice Address - Country:US
Practice Address - Phone:610-779-4896
Practice Address - Fax:610-370-5201
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018860225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist