Basic Information
| Provider Information | |||||||||
| NPI: | 1205100708 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOWDERS | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | KEITH | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7675 OAK HILL RD NE | ||||||||
| Address2: | |||||||||
| City: | BREMEN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431079711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403042772 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2000 REGENCY MANOR CIR | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432071777 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144458261 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/29/2012 | ||||||||
| LastUpdateDate: | 02/29/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 7644 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.