Individual
JACK DOUGLAS BOWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
647 ELY ST, ALLEGAN, MI 49010-1541
(269) 601-0204
Mailing address
647 ELY ST, ALLEGAN, MI 49010-1541
(269) 601-0204
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5502003851
MI
Other
Enumeration date
08/29/2013
Last updated
08/29/2013
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