Provider Demographics
NPI:1275376188
Name:BOWDEN, JOHN MARTIN (PT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MARTIN
Last Name:BOWDEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3093 FRAZIER WALK
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-1856
Mailing Address - Country:US
Mailing Address - Phone:404-931-3528
Mailing Address - Fax:
Practice Address - Street 1:3093 FRAZIER WALK
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-1856
Practice Address - Country:US
Practice Address - Phone:404-931-3528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT005257225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist