Individual
MICHAEL BOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC. LAT.
Contact information
Practice address
2600 W MAIN ST, BELLEVILLE, IL 62226-6651
(618) 239-6000
Mailing address
591 HICKORY LN, CHARLESTON, IL 61920-4421
(217) 549-4133
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003762
IL
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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