Basic Information
| Provider Information | |||||||||
| NPI: | 1508596446 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOWERS | ||||||||
| FirstName: | NEAL | ||||||||
| MiddleName: | EDWARD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 143 FAIRWAY DR | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN TOP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 187079082 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708850452 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 BROOKHILL SQ S | ||||||||
| Address2: | |||||||||
| City: | SUGARLOAF | ||||||||
| State: | PA | ||||||||
| PostalCode: | 182491016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8887264774 | ||||||||
| FaxNumber: | 5703625112 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2022 | ||||||||
| LastUpdateDate: | 06/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | Y |
No ID Information.