Provider Demographics
NPI:1740296078
Name:BOWEN, JAMES PATRICK (PT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PATRICK
Last Name:BOWEN
Suffix:
Gender:M
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:PO BOX 884
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-0884
Mailing Address - Country:US
Mailing Address - Phone:931-836-2221
Mailing Address - Fax:931-836-2223
Practice Address - Street 1:113 E BOCKMAN WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-2061
Practice Address - Country:US
Practice Address - Phone:931-836-2221
Practice Address - Fax:931-836-2223
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000007614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist