Provider Demographics
NPI:1053023325
Name:MOWERY, SYLVIA RYANNE
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:RYANNE
Last Name:MOWERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 APPALOOSA ST
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-7398
Mailing Address - Country:US
Mailing Address - Phone:304-880-0402
Mailing Address - Fax:
Practice Address - Street 1:215 APPALOOSA ST
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-7398
Practice Address - Country:US
Practice Address - Phone:304-880-0402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist