Individual
MR. JACOB BOWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1955 VERNON ST, WABASH, IN 46992-4026
(260) 563-8438
Mailing address
853 COLUMBIA AVE APT WEST, FORT WAYNE, IN 46805-4305
(260) 582-1399
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004452A
IN
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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