Provider Demographics
NPI:1376941393
Name:BOWERS, JOHN C (MS, OTR/L)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:BOWERS
Suffix:
Gender:M
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-1335
Mailing Address - Country:US
Mailing Address - Phone:859-985-7036
Mailing Address - Fax:
Practice Address - Street 1:162 MORGAN ST
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1335
Practice Address - Country:US
Practice Address - Phone:859-985-7036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYBOTOCT00212176225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist