Individual
STORM BOWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
407TH SSA TAYLOR STREET BLDG A2530, FORT BRAGG, NC 28310-0001
(207) 930-0358
Mailing address
736 CL TART CIR APT 301, FAYETTEVILLE, NC 28314-3144
(207) 930-0358
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT797
ME
2255A2300X
Athletic Trainer
Primary
LAT-3973
NC
2255A2300X
Athletic Trainer
RT006882
PA
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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