Healthcare Provider Details

I. General information

NPI: 1538695473
Provider Name (Legal Business Name): KYLIE E ROWE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 01/02/2021
Certification Date: 01/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 DUNCAN ST APT 305F
SAN FRANCISCO CA
94131-1863
US

IV. Provider business mailing address

970 DUNCAN ST APT 305F
SAN FRANCISCO CA
94131-1863
US

V. Phone/Fax

Practice location:
  • Phone: 701-730-2672
  • Fax: 415-906-2056
Mailing address:
  • Phone: 701-730-2672
  • Fax: 415-906-2056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number40642
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number40642
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number40642
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number40642
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: