Provider Demographics
NPI:1437541851
Name:SPROWLES, DOROTHY ANN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:ANN
Last Name:SPROWLES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:A
Other - Last Name:SPROWLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:7401 EDGEFIELD CT
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-3310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:487 LAKE CONCORD RD NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2934
Practice Address - Country:US
Practice Address - Phone:704-403-0291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-22
Last Update Date:2015-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant