Basic Information
| Provider Information | |||||||||
| NPI: | 1104874403 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOWER | ||||||||
| FirstName: | MARGERY | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | P.A.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P. O. BOX 320 | ||||||||
| Address2: | |||||||||
| City: | PLAINFIELD | ||||||||
| State: | VT | ||||||||
| PostalCode: | 056670320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8024548336 | ||||||||
| FaxNumber: | 8024548339 | ||||||||
| Practice Location | |||||||||
| Address1: | 157 TOWNE AVE | ||||||||
| Address2: | |||||||||
| City: | PLAINFIELD | ||||||||
| State: | VT | ||||||||
| PostalCode: | 056679425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8024548336 | ||||||||
| FaxNumber: | 8024548339 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2006 | ||||||||
| LastUpdateDate: | 02/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 055-0030646 | VT | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.