Provider Demographics
NPI:1467583575
Name:COWELL, DANIEL R (ATC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:R
Last Name:COWELL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 ACADEMY RD
Mailing Address - Street 2:#3
Mailing Address - City:CULVER
Mailing Address - State:IN
Mailing Address - Zip Code:46511-1234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 ACADEMY RD
Practice Address - Street 2:#3
Practice Address - City:CULVER
Practice Address - State:IN
Practice Address - Zip Code:46511-1234
Practice Address - Country:US
Practice Address - Phone:574-842-7075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer