MEDICARE: MISS TAMATHA SUZANNE ROWE D.C.

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
1	111N00000X	Chiropractor	3348	OK

General Provider Information

NPI Number	:	1851333934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS TAMATHA SUZANNE ROWE D.C.

Provider Business Mailing Address
First Line	:	9616 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-2714
Country	:	US
Telephone Number	:	405-749-2225
Fax Number	:	405-748-6196

Provider Business Practice Location Address
First Line	:	9616 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-2714
Country	:	US
Telephone Number	:	405-749-2225
Fax Number	:	405-748-6196

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	06/15/2012

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