Healthcare Provider Details

I. General information

NPI: 1396815544
Provider Name (Legal Business Name): JERI ROWLEY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1681 COMMERCE DR
NORTH MANKATO MN
56003-1913
US

IV. Provider business mailing address

2399 ARIEL ST N SUITE B
MAPLEWOOD MN
55109-2203
US

V. Phone/Fax

Practice location:
  • Phone: 507-625-8017
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4878
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: