Healthcare Provider Details

I. General information

NPI: 1497638696
Provider Name (Legal Business Name): KEVIN ROWE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13640 MARSHALL HIGHWAY
JOLO WV
24850
US

IV. Provider business mailing address

PO BOX 329
BRADSHAW WV
24817-0329
US

V. Phone/Fax

Practice location:
  • Phone: 304-887-4169
  • Fax:
Mailing address:
  • Phone: 304-987-4169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: