Provider Demographics
NPI:1437625944
Name:BOWDEN WEIGHT LOSS CENTER
Entity Type:Organization
Organization Name:BOWDEN WEIGHT LOSS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SEANDRIA
Authorized Official - Middle Name:F
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-272-7200
Mailing Address - Street 1:3280 HOWELL MILL RD NW STE 233
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4100
Mailing Address - Country:US
Mailing Address - Phone:901-272-7200
Mailing Address - Fax:901-272-0820
Practice Address - Street 1:3280 HOWELL MILL RD NW STE 233
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4100
Practice Address - Country:US
Practice Address - Phone:901-272-7200
Practice Address - Fax:901-272-0820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service