Provider Demographics
NPI:1831167840
Name:BOWERS, DAVID LEE (PT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEE
Last Name:BOWERS
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 1:2110 S EAGLE RD STE 393
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1574
Mailing Address - Country:US
Mailing Address - Phone:215-741-9315
Mailing Address - Fax:215-741-9317
Practice Address - Street 1:650 DURHAM RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:215-741-9315
Practice Address - Fax:215-741-9317
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006025L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000742779OtherHIGHMARK BLUE SHIELD
PA0014401380002Medicaid
PA065343700OtherIBC