Provider Demographics
NPI:1578908125
Name:GOW, STEPHANIE LEIGH (DPT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LEIGH
Last Name:GOW
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2547
Mailing Address - Country:US
Mailing Address - Phone:603-228-7500
Mailing Address - Fax:
Practice Address - Street 1:171 PLEASANT ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2547
Practice Address - Country:US
Practice Address - Phone:603-228-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3784225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist