Individual
DR. ANDREA BOWMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1421 S 11TH ST, NILES, MI 49120-4201
(269) 684-1330
(269) 684-3353
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18002528
IN
152W00000X
Optometrist
Primary
4901004472
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100341250
—
IN
Enumeration date
06/10/2006
Last updated
04/02/2021
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