Provider Demographics
NPI:1265864573
Name:FOWLER, BRITTANY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:FOWLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12450 CLEVELAND RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-8353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12450 CLEVELAND RD
Practice Address - Street 2:SUITE 201
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-8353
Practice Address - Country:US
Practice Address - Phone:919-771-0775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14360225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist