Provider Demographics
NPI:1780294504
Name:BOWEN, AMI (PT, DPT)
Entity type:Individual
Prefix:
First Name:AMI
Middle Name:
Last Name:BOWEN
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:AMI
Other - Middle Name:JO
Other - Last Name:MILLIGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4606 CLYDE MORRIS BLVD
Mailing Address - Street 2:STE 1D
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-7453
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5969 N CANTON CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2757
Practice Address - Country:US
Practice Address - Phone:877-407-3422
Practice Address - Fax:877-407-4329
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT36035225100000X
MI5501303813225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist