Provider Demographics
NPI:1447595053
Name:MCOWAN, DANA KRISTIN (LPTA)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:KRISTIN
Last Name:MCOWAN
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 TOWNSHIP PKWY
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-9636
Mailing Address - Country:US
Mailing Address - Phone:205-585-0497
Mailing Address - Fax:
Practice Address - Street 1:1209 TOWNSHIP PKWY
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-9636
Practice Address - Country:US
Practice Address - Phone:205-585-0497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-07
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5078225200000X
NCA6791225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant