Provider Demographics
NPI:1932196003
Name:BOWDEN, HENRY TODD (ATC)
Entity type:Individual
Prefix:MR
First Name:HENRY
Middle Name:TODD
Last Name:BOWDEN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 AHLSTRAND
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-4153
Mailing Address - Country:US
Mailing Address - Phone:479-306-8633
Mailing Address - Fax:
Practice Address - Street 1:500 S MOUNT OLIVE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-3602
Practice Address - Country:US
Practice Address - Phone:479-524-6306
Practice Address - Fax:479-524-6096
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAT1112255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer