Provider Demographics
NPI:1750983151
Name:BOWEN, CATHERINE NICOLE (DPT)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:NICOLE
Last Name:BOWEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:NICOLE
Other - Last Name:MANUEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1326 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-2743
Mailing Address - Country:US
Mailing Address - Phone:225-654-8208
Mailing Address - Fax:225-654-4642
Practice Address - Street 1:425 SETTLERS TRACE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6048
Practice Address - Country:US
Practice Address - Phone:337-233-0322
Practice Address - Fax:337-233-0225
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10711225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist