Provider Demographics
NPI:1114487915
Name:COWAN, JAMIE RAE (DPT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:RAE
Last Name:COWAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8205 W WARM SPRINGS RD STE 250
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3646
Mailing Address - Country:US
Mailing Address - Phone:702-227-2152
Mailing Address - Fax:702-252-0369
Practice Address - Street 1:8205 W WARM SPRINGS RD STE 250
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3646
Practice Address - Country:US
Practice Address - Phone:702-227-2152
Practice Address - Fax:702-252-0369
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist