Individual
LAUREN DEANN BOUWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, CLT
Contact information
Practice address
16000 W 101ST AVE, DYER, IN 46311-3065
(219) 365-6333
(219) 365-8291
Mailing address
15900 W 101ST AVE, DYER, IN 46311-3065
(219) 365-6333
(219) 365-8291
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010491A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05010491A
LICENSE
IN
Enumeration date
12/03/2012
Last updated
04/09/2021
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