Provider Demographics
NPI:1801128855
Name:BOWERS, TASHA (LMT)
Entity type:Individual
Prefix:
First Name:TASHA
Middle Name:
Last Name:BOWERS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1523 W HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-1207
Mailing Address - Country:US
Mailing Address - Phone:813-251-5290
Mailing Address - Fax:813-251-5672
Practice Address - Street 1:1523 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1207
Practice Address - Country:US
Practice Address - Phone:813-251-5290
Practice Address - Fax:813-251-5672
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL43056111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner