Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5201002232 | MI |
NPI | 1134476906 |
---|---|
Provider Name | Mrs. Lori Dyhrberg Bowie |
First Address | Holly, MI 48442-1911 |
Second Address | Grand Blanc, MI 48439-1702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2012 |
Last Update Date | 10/08/2012 |