Provider Demographics
NPI:1912246935
Name:BOWMAN, REBECCA LELONEK (DPT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LELONEK
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:KATHLEEN
Other - Last Name:LELONEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1645 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-5007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1645 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-5007
Practice Address - Country:US
Practice Address - Phone:814-875-8800
Practice Address - Fax:814-875-8756
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022234225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist