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NPI Code Detail

MEDICARE: DR. JOHN ERIC MCCOWN P.T., D.P.T

MEDICARE: DR. JOHN ERIC MCCOWN P.T., D.P.T
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2613WV

General Provider Information

NPI Number : 1295007524
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN ERIC MCCOWN P.T., D.P.T
Provider Business Mailing Address
First Line : 113 LAKEVIEW DR
Second Line :
City : CHARLESTON
State : WV
Zip : 25313-1467
Country : US
Telephone Number : 304-342-9515
Fax Number :
Provider Business Practice Location Address
First Line : 113 LAKEVIEW DR
Second Line :
City : CHARLESTON
State : WV
Zip : 25313-1467
Country : US
Telephone Number : 304-342-9515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2012
Last Update Date : 02/02/2012

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