Provider Demographics
NPI:1558884999
Name:ROWAN, LYNN MARIE (PT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:ROWAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 BELLE TERRE BLVD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-4739
Mailing Address - Country:US
Mailing Address - Phone:985-630-9754
Mailing Address - Fax:
Practice Address - Street 1:67252 INDUSTRY LN
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8704
Practice Address - Country:US
Practice Address - Phone:985-801-6265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07208R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist