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General NPI Number Information
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NPI Number | 1366850638
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Entity Type | Organization
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Legal Business Name | LYNETTE ROWE PHYSICAL THERAPY
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Dates
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Enumeration Date | 07/30/2014
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Last Update Date | 07/30/2014
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Provider Practice Location Address
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Address Line | 5600 PONY EXPRESS TRL # A
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City | CAMINO
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State | CA
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Zip | 95709-9624
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Country | US
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Telephone | 530-644-5225
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Fax | 530-644-5777
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Provider Business Mailing Address
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Address Line | 331 DIANA ST
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City | PLACERVILLE
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State | CA
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Zip | 95667-3317
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Country | US
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Telephone | 530-644-5225
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Fax | 530-644-5777
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Authorized Official
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Title or Position | P.T./OWNER
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Name | MRS. KATHRINA LYNETTE ROWE
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Credential |
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Telephone | 530-644-5225
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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 | PT10785
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License Number State | CA
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