Provider Demographics
NPI:1972751667
Name:BOWMAN, JULIA HURST (MED)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:HURST
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:MARIE
Other - Last Name:HURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:518 W ASPEN WAY
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-2129
Mailing Address - Country:US
Mailing Address - Phone:309-839-0301
Mailing Address - Fax:
Practice Address - Street 1:518 W ASPEN WAY
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-2129
Practice Address - Country:US
Practice Address - Phone:309-839-0301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist