Basic Information
| Provider Information | |||||||||
| NPI: | 1609085398 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOWEN | ||||||||
| FirstName: | KENDRA | ||||||||
| MiddleName: | LEIGH | ||||||||
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| Credential: | OTRL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 504 N CARRIE ST | ||||||||
| Address2: | |||||||||
| City: | MCPHERSON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674603714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6205042772 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1202 E 23RD AVE | ||||||||
| Address2: | |||||||||
| City: | HUTCHINSON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 675025656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6206699393 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2007 | ||||||||
| LastUpdateDate: | 06/28/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 17 02799 | KS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.