Provider Demographics
NPI:1679785679
Name:ROWELL, MICHAEL DARON (OTR-L)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DARON
Last Name:ROWELL
Suffix:
Gender:M
Credentials:OTR-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2397 SOWELL RD
Mailing Address - Street 2:
Mailing Address - City:BREWTON
Mailing Address - State:AL
Mailing Address - Zip Code:36426-2901
Mailing Address - Country:US
Mailing Address - Phone:251-867-3040
Mailing Address - Fax:251-809-1715
Practice Address - Street 1:109 SAINT JOSEPH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BREWTON
Practice Address - State:AL
Practice Address - Zip Code:36426-2055
Practice Address - Country:US
Practice Address - Phone:251-867-3040
Practice Address - Fax:251-809-1715
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1873225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist