Provider Demographics
NPI:1366659237
Name:BOWEN, DARLENE AMANDA (PTA)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:AMANDA
Last Name:BOWEN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 E CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-3506
Mailing Address - Country:US
Mailing Address - Phone:219-688-3351
Mailing Address - Fax:
Practice Address - Street 1:2640 E CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-3506
Practice Address - Country:US
Practice Address - Phone:219-688-3351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06002394A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant