Provider Demographics
NPI:1972245264
Name:BOWERS, EARLE EUGENE
Entity type:Individual
Prefix:
First Name:EARLE
Middle Name:EUGENE
Last Name:BOWERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 TERRI LN
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-4714
Mailing Address - Country:US
Mailing Address - Phone:276-235-1501
Mailing Address - Fax:
Practice Address - Street 1:70 TERRI LN
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-4714
Practice Address - Country:US
Practice Address - Phone:276-235-1501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker