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General NPI Number Information
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NPI Number | 1003594052
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Entity Type | Individual
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Provider Name | LAURA JEAN MCGOWAN PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 620 WESTFALL RD
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City | ROCHESTER
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State | NY
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Zip | 14620-4610
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Country | US
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Telephone | 585-461-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 96 EAST ST
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City | HONEOYE FALLS
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State | NY
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Zip | 14472-1229
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Country | US
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Telephone | 585-749-9879
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 050250
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License Number State | NY
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