Provider Demographics
NPI:1619380011
Name:NOWLIN, CHAD (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:
Last Name:NOWLIN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-6781
Mailing Address - Country:US
Mailing Address - Phone:903-413-8117
Mailing Address - Fax:
Practice Address - Street 1:2208 SMITH RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-6781
Practice Address - Country:US
Practice Address - Phone:903-413-8117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN050122070A225100000X
TX3115599225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141625702Medicaid
TX141625702Medicaid