| NPI | 1730463852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EAGLE BOWERS Owner 623-215-2525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2011-11-30 |