Basic Information
| Provider Information | |||||||||
| NPI: | 1073125829 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOWERS | ||||||||
| FirstName: | ABBY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4637 MARION MARYSVILLE RD | ||||||||
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| City: | PROSPECT | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43342 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 351 S LANE ST | ||||||||
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| City: | BUCYRUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448202319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195626686 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2020 | ||||||||
| LastUpdateDate: | 08/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 011123 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.