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General NPI Number Information
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NPI Number | 1295239481
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Entity Type | Individual
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Provider Name | REBECCA SHANNON SOWERS
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Gender | Female
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 16455 E AVENUE OF THE FOUNTAINS
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85268-8307
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Country | US
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Telephone | 480-351-7641
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Fax |
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Provider Business Mailing Address
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Address Line | 610 E GILBERT DR APT 132
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City | TEMPE
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State | AZ
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Zip | 85281-2058
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Country | US
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Telephone | 301-502-1690
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 13634APTA
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License Number State | AZ
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