Provider Demographics
NPI:1831646975
Name:BOWSER, SARAH (MS, LAT, ATC, OTC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BOWSER
Suffix:
Gender:F
Credentials:MS, LAT, ATC, OTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10275 QUAIL CREEK PLACE
Mailing Address - Street 2:
Mailing Address - City:IJAMSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21754
Mailing Address - Country:US
Mailing Address - Phone:301-873-0098
Mailing Address - Fax:
Practice Address - Street 1:2861 NE INDEPENDENCE AVE STE 201
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2379
Practice Address - Country:US
Practice Address - Phone:165-252-8408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20210340462255A2300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer