Provider Demographics
NPI:1720110117
Name:BOWERS, ROBERT S SR
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:S
Last Name:BOWERS
Suffix:SR
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 1:700 SOUTH SYCAMORE ST
Mailing Address - Street 2:STE #13
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-5804
Mailing Address - Country:US
Mailing Address - Phone:804-733-8360
Mailing Address - Fax:804-733-1916
Practice Address - Street 1:700 SOUTH SYCAMORE ST
Practice Address - Street 2:STE #13
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-5804
Practice Address - Country:US
Practice Address - Phone:804-733-8360
Practice Address - Fax:804-733-1916
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist