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Individual

FRED EUGENE BOWEN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
2840 OAK HAVEN PL, COOKEVILLE, TN 38506-6172
(931) 510-6326
Mailing address
2840 OAK HAVEN PL, COOKEVILLE, TN 38506-6172
(931) 510-6326

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000000512
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0092237
BLUE CROSS BLUE SHIELD
TN
Enumeration date
10/27/2005
Last updated
04/23/2013
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