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1497889422
BLAKE RAYMOND BOWERS
COOS BAY, OR
NPI
1497889422
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: OR AT-AT-367795)
Enumeration Date
2007-03-14
Last Update Date
2007-07-08
Business Address
-- BLAKE RAYMOND BOWERS ATC
1988 NEWMARK AVE
COOS BAY, OR 97420-2911
Phone number: 541-888-7430
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Mailing Address
-- BLAKE RAYMOND BOWERS ATC
2770 32ND ST
COOS BAY, OR 97420-3541
Phone number: 541-888-7430
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