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General NPI Number Information
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NPI Number | 1821063330
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Entity Type | Individual
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Provider Name | HAROLD W ROWALD MS, ATC, CSCS
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Gender | Male
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Dates
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Enumeration Date | 02/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2345 MAIN ST
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City | GLASTONBURY
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State | CT
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Zip | 06033-2211
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Country | US
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Telephone | 860-633-5572
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Fax |
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Provider Business Mailing Address
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Address Line | 197 COCHRAN RD
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City | MURPHYSBORO
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State | IL
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Zip | 62966-3208
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Country | US
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Telephone | 618-684-3315
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | IL
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