Provider Demographics
NPI:1053424614
Name:BOWER, CELIA J (PT)
Entity type:Individual
Prefix:MRS
First Name:CELIA
Middle Name:J
Last Name:BOWER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2715 PATIO ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-2137
Mailing Address - Country:US
Mailing Address - Phone:903-759-1509
Mailing Address - Fax:903-295-0099
Practice Address - Street 1:2715 PATIO ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-2137
Practice Address - Country:US
Practice Address - Phone:903-759-1509
Practice Address - Fax:903-295-0099
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11323302251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T4394OtherBC/BS PROVIDER NUMBER