Individual
ELENA BOWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
18942 DALE MABRY HWY N, SUITE 102, LUTZ, FL 33548-4907
(813) 909-0961
(813) 909-2086
Mailing address
18942 DALE MABRY HWY N, SUITE 102, LUTZ, FL 33548-4907
(813) 909-0961
(813) 909-2086
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA49885
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA49885
FLORIDA LICENSE
FL
Enumeration date
10/22/2007
Last updated
10/22/2007
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