Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT 26449 | FL |
NPI | 1003101361 |
---|---|
Provider Name | Ms. Kathleen M Bower |
First Address | Coral Gables, FL 33146-3087 |
Second Address | Coral Gables, FL 33146-3087 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2011 |
Last Update Date | 15/06/2011 |