Stewart Wilson Bowers, ATC

Individual provider Active NPI Athletic Trainer · Columbia, SC

NPI 1578093985 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1578093985
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
AT003056 (GA)
Practice address
Blatt Pe Center Exercise Science 1300 Wheat St
Columbia, SC 29208-0001
Phone
(803) 777-0636
NPI assigned
Jun 18, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AT003056GAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT003056 GA Yes

Addresses

Primary practice location

Blatt Pe Center Exercise Science 1300 Wheat St
Columbia, SC 29208-0001

Mailing address

Blatt Pe Center Exercise Science 1300 Wheat St
Columbia, SC 29208-0001
Phone (803) 777-0636

Other providers in Columbia, SC

All providers in Columbia, SC · Athletic Trainer in South Carolina

Sources for this page

Verify at the official NPI Registry.