Individual
GARY ANTHONY RUDOLPH BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1014 SYCAMORE DR, SUITE B, DECATUR, GA 30030-1644
(404) 480-4229
Mailing address
825 COMMON OAK PL, LAWRENCEVILLE, GA 30045-8256
(210) 781-3997
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7262
GA
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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