Individual
LISA BOWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
407 OFFUTT SCHOOL ROAD, AUGUSTA, WV 26704
(304) 268-7611
Mailing address
407 OFFUTT SCHOOL RD, AUGUSTA, WV 26704-7279
(304) 268-7611
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604354
VA
225200000X
Physical Therapy Assistant
PTA 001705
WV
Other
Enumeration date
04/03/2017
Last updated
04/03/2017
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