Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 095332 | IA |
NPI | 1013685882 |
---|---|
Provider Name | Luzviminda Bowers |
First Address | Pella, IA 50219-1438 |
Second Address | Pella, IA 50219-1438 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2021 |
Last Update Date | 07/09/2021 |