Basic Information
| Provider Information | |||||||||
| NPI: | 1780644450 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOWERS | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 W 10TH ST | ||||||||
| Address2: | |||||||||
| City: | MARCUS HOOK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190614513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108598850 | ||||||||
| FaxNumber: | 6108597876 | ||||||||
| Practice Location | |||||||||
| Address1: | 4301 PENN AVE | ||||||||
| Address2: | |||||||||
| City: | SINKING SPRING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 196081370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109274136 | ||||||||
| FaxNumber: | 6109274139 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2006 | ||||||||
| LastUpdateDate: | 04/21/2011 | ||||||||
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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 | 225100000X | PT016907 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 1629760 | 01 | PA | HIGHMARK PA BLUE SHIELD | OTHER | 1629760 | 01 | PA | FREEDOM BLUE | OTHER | 286017 | 01 | UNISON | OTHER | 30070837 | 01 | PA | KEYSTONE MERCY | OTHER | 286017 | 01 | PA | AMERICHOICE | OTHER | 101004787-0002 | 05 | PA | MEDICAID | 23056542000 | 01 | PA | IBC | OTHER | 50090600 | 01 | PA | CAPITAL BLUE CROSS | OTHER |