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General NPI Number Information
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NPI Number | 1417436908
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Entity Type | Individual
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Provider Name | KEVIN BARRETT ROWLEY
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Gender | Male
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Dates
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Enumeration Date | 08/07/2018
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Last Update Date | 08/07/2018
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Provider Practice Location Address
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Address Line | 2484 INGLESIDE AVE STE B201
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City | MACON
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State | GA
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Zip | 31204-6515
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Country | US
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Telephone | 478-918-5933
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Fax |
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Provider Business Mailing Address
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Address Line | 774 LITTLE JOHN CT
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City | MACON
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State | GA
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Zip | 31220-2725
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Country | US
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Telephone | 478-918-5933
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT0001884
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License Number State | GA
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