Provider Demographics
NPI:1710910658
Name:BOWER, LAURA SANTANA (PT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:SANTANA
Last Name:BOWER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 CASTINE CT
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-2103
Mailing Address - Country:US
Mailing Address - Phone:916-363-1701
Mailing Address - Fax:
Practice Address - Street 1:3401 FOLSOM BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5354
Practice Address - Country:US
Practice Address - Phone:916-455-5524
Practice Address - Fax:916-455-5524
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT269301225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT269302Medicare PIN