Provider Demographics
NPI:1124147699
Name:BOWERS, GARILEE MARIE
Entity type:Individual
Prefix:MRS
First Name:GARILEE
Middle Name:MARIE
Last Name:BOWERS
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 1:8410 JACKSON HILL RD
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13309-4314
Mailing Address - Country:US
Mailing Address - Phone:315-942-6651
Mailing Address - Fax:
Practice Address - Street 1:1657 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5415
Practice Address - Country:US
Practice Address - Phone:315-797-7392
Practice Address - Fax:315-734-9041
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021622-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist