Provider Demographics
NPI:1528492741
Name:BOWYER, KIM-THUY (LMT, CMRMT, BS)
Entity type:Individual
Prefix:
First Name:KIM-THUY
Middle Name:
Last Name:BOWYER
Suffix:
Gender:F
Credentials:LMT, CMRMT, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 BETHEL RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2775
Mailing Address - Country:US
Mailing Address - Phone:614-273-0810
Mailing Address - Fax:614-273-0173
Practice Address - Street 1:1151 BETHEL RD
Practice Address - Street 2:SUITE 302
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2775
Practice Address - Country:US
Practice Address - Phone:614-273-0810
Practice Address - Fax:614-273-0173
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7452225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist