Individual provider · NPI-1

Brian Clarence Bowick

Physical Therapy Assistant · Marietta, GA

NPI number1972799344
StatusActive
Last updated in NPPESSep 19, 2007

Details

NPI
1972799344
Entity type
Individual (NPI-1)
Name
Brian Clarence Bowick
Sex
Male
Sole proprietor
Yes
Enumeration date
Sep 19, 2007
Last updated
Sep 19, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy Assistantpta001903GAYes

Practice location

2712 Chelwick Dr Sw
Marietta, GA 30008-8172

Phone 843-819-5742

Mailing address

2070 Coker Ave
Charleston, SC 29412-2172

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