Traci Bowman
Individual provider Active NPI Physical Therapist · Kingsport, TN
NPI 1871979500 · NPPES record last updated Aug 4, 2015
Key facts
- NPI
- 1871979500
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 6403 (TN)
- Practice address
- 1718 Bridle CT
Kingsport, TN 37663-3778 - Phone
- (423) 367-5210
- NPI assigned
- Aug 4, 2015
- Sex
- Female
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6403 | TN | Yes |
Addresses
Primary practice location
1718 Bridle CT
Kingsport, TN 37663-3778
Mailing address
1718 Bridle CT
Kingsport, TN 37663-3778
Phone (423) 367-5210
Other providers in Kingsport, TN
- Renee L Boulicault
- Melanie Creppel Bourgeois
- Vickie R Bowen
- Carissa Renee Bowery
- Jacqlyne Weber Bowman
- Abigail L Box
- Denni Larae Boyd
- Gregory Evan Boykin
- John W Boyle
- Stephanie Smith Boyles
All providers in Kingsport, TN · Physical Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.