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Individual

NAM GIN PAUL BOWMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1099 EDGEWATER CORPORATE PKWY, INDIAN LAND, SC 29707-4516
(803) 833-0077
Mailing address
1626 SASSAFRAS CT, FORT MILL, SC 29715-0183
(803) 221-9699

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3780
SC

Other

Enumeration date
04/15/2018
Last updated
10/01/2018
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