Provider Demographics
NPI:1598090391
Name:J PATRICK BOWEN
Entity Type:Organization
Organization Name:J PATRICK BOWEN
Other - Org Name:BOWEN PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:931-836-2221
Mailing Address - Street 1:PO BOX 884
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-0884
Mailing Address - Country:US
Mailing Address - Phone:931-836-2221
Mailing Address - Fax:931-836-2223
Practice Address - Street 1:113 E BOCKMAN WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-2061
Practice Address - Country:US
Practice Address - Phone:931-836-2221
Practice Address - Fax:931-836-2223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-12
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000007612174400000X
TNPT0000007614174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4203083OtherBLUE CROSS BLUE SHIELD