Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 05001078A | IN |
NPI | 1003188822 |
---|---|
Provider Name | Carolyn Victoria Bowden |
First Address | Franklin, IN 46131-2140 |
Second Address | Franklin, IN 46131-2140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2012 |
Last Update Date | 31/07/2012 |