Individual
DYLAN LEE BOWERSOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2380 WILDWOOD RD, MIFFLINBURG, PA 17844-8250
(570) 428-5047
Mailing address
2380 WILDWOOD RD, MIFFLINBURG, PA 17844-8250
(570) 428-5047
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RTO000232
PA
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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