Individual
AARON BOWLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1023 S CEDAR RD, NEW LENOX, IL 60451-2645
(815) 463-8880
Mailing address
346 SHABBONA DR, PARK FOREST, IL 60466-1949
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160005754
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103432449
—
IL
Enumeration date
07/13/2017
Last updated
08/18/2021
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