Provider Demographics
NPI:1447523931
Name:BOWMAN, STEPHANIE LEIGH (ATC, LAT)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:LEIGH
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7828 COUNTRY KNOLL
Mailing Address - Street 2:
Mailing Address - City:BAHAMA
Mailing Address - State:NC
Mailing Address - Zip Code:27503-8820
Mailing Address - Country:US
Mailing Address - Phone:919-698-2358
Mailing Address - Fax:
Practice Address - Street 1:4400 GOLF ACRES DR
Practice Address - Street 2:BUILDING J, SUITE D
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28232-5990
Practice Address - Country:US
Practice Address - Phone:919-698-2358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16832255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer