Provider Demographics
NPI:1881408979
Name:BOWLES, BRADY ALAN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:BRADY
Middle Name:ALAN
Last Name:BOWLES
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-4010
Mailing Address - Country:US
Mailing Address - Phone:580-256-2102
Mailing Address - Fax:
Practice Address - Street 1:2630 OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-4010
Practice Address - Country:US
Practice Address - Phone:580-256-2102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist