Provider Demographics
NPI:1164604567
Name:DR ROB ROWE INC PC
Entity Type:Organization
Organization Name:DR ROB ROWE INC PC
Other - Org Name:CENTRAL OKLAHOMA WELLNESS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-632-0003
Mailing Address - Street 1:912 STRAKA TER
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2534
Mailing Address - Country:US
Mailing Address - Phone:405-632-0003
Mailing Address - Fax:405-632-3773
Practice Address - Street 1:912 STRAKA TER
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2534
Practice Address - Country:US
Practice Address - Phone:405-632-0003
Practice Address - Fax:405-632-3773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2615111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU24343Medicare UPIN