Provider Demographics
NPI:1679633689
Name:BOWMAN, NAOMI (P T)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5909 WOODFIELD ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-1870
Mailing Address - Country:US
Mailing Address - Phone:703-434-2022
Mailing Address - Fax:
Practice Address - Street 1:5909 WOODFIELD ESTATES DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-1870
Practice Address - Country:US
Practice Address - Phone:703-434-2022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist