Provider Demographics
NPI:1336964725
Name:BOWMAN, AMBER KAY (DPT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:KAY
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W WILLIS RD APT 3100
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-6546
Mailing Address - Country:US
Mailing Address - Phone:218-232-8120
Mailing Address - Fax:
Practice Address - Street 1:1445 E WILLIS RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-7352
Practice Address - Country:US
Practice Address - Phone:602-529-1030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-033889225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist