BLAKE RAYMOND BOWERS

COOS BAY, OR
NPI1497889422
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: OR  AT-AT-367795)
Enumeration Date2007-03-14
Last Update Date2007-07-08
Business Address
-- BLAKE RAYMOND BOWERS ATC
1988 NEWMARK AVE
COOS BAY, OR 97420-2911
Phone number: 541-888-7430
Mailing Address
-- BLAKE RAYMOND BOWERS ATC
2770 32ND ST
COOS BAY, OR 97420-3541
Phone number: 541-888-7430
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