Provider Demographics
NPI:1972371193
Name:SOWERS, RYAN ANDREW
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:ANDREW
Last Name:SOWERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47932-1467
Mailing Address - Country:US
Mailing Address - Phone:765-585-0802
Mailing Address - Fax:
Practice Address - Street 1:417 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:IN
Practice Address - Zip Code:47932-1245
Practice Address - Country:US
Practice Address - Phone:765-585-0802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist