MEDICARE: JANICE MARIE ROWE PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	2127377	TX

General Provider Information

NPI Number	:	1316463425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE MARIE ROWE PTA

Provider Business Mailing Address
First Line	:	2431 S LOOP 289
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79423-1519
Country	:	US
Telephone Number	:	806-771-8008
Fax Number	:	806-771-8009

Provider Business Practice Location Address
First Line	:	4642 N LOOP 289 STE 205
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79416-2424
Country	:	US
Telephone Number	:	806-771-1352
Fax Number	:	806-771-1356

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2017
Last Update Date	:	03/17/2018

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