Provider Demographics
NPI:1477804177
Name:BOWMAN, SARAH (PTA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BOWMAN
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 1:8301 OLD SAUK RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-4389
Mailing Address - Country:US
Mailing Address - Phone:608-662-8866
Mailing Address - Fax:608-827-9667
Practice Address - Street 1:8301 OLD SAUK RD
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-4389
Practice Address - Country:US
Practice Address - Phone:608-662-8866
Practice Address - Fax:608-827-9667
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1897-19225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant