Healthcare Provider Details

I. General information

NPI: 1629791355
Provider Name (Legal Business Name): ALLISON ROWAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 FRONT ST
CHICOPEE MA
01013-3140
US

IV. Provider business mailing address

6 ROSALIE LN
SOUTHAMPTON MA
01073-9217
US

V. Phone/Fax

Practice location:
  • Phone: 413-420-2222
  • Fax:
Mailing address:
  • Phone: 413-207-7137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: