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Organization

WESTERN TRAILS PHYSICAL THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN WESLY BOWLIN D.P.T. (OWNER/MANAGER/PRESIDENT)
(308) 623-1313
Entity
Organization

Contact information

Practice address
1463 19TH AVE, SUITE B, MITCHELL, NE 69357-1455
(308) 623-1313
(308) 623-1315
Mailing address
1463 19TH AVE, SUITE B, MITCHELL, NE 69357-1455
(308) 623-1313
(308) 623-1315

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2684
NE

Other

Enumeration date
03/31/2011
Last updated
03/31/2011
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