Provider Demographics
NPI:1417328923
Name:BOWLES, HEATHER (DPT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BOWLES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12510 WINFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:25213-0000
Mailing Address - Country:US
Mailing Address - Phone:304-743-4954
Mailing Address - Fax:304-743-0291
Practice Address - Street 1:12510 WINFIELD ROAD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:WV
Practice Address - Zip Code:25213-0000
Practice Address - Country:US
Practice Address - Phone:304-586-4200
Practice Address - Fax:304-586-4500
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT 003554225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist