| NPI | 1902028483 |
|---|---|
| Former Name | STACY BOWEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 007820) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT CT 007820) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2022-07-26 |