Provider Demographics
NPI:1750687315
Name:ROWLEY, SONDRA (PTA)
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:
Last Name:ROWLEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 LEXINGTON AVE S APT 2
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-1145
Mailing Address - Country:US
Mailing Address - Phone:813-245-4858
Mailing Address - Fax:
Practice Address - Street 1:3530 LEXINGTON AVE S APT 2
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-1145
Practice Address - Country:US
Practice Address - Phone:813-245-4858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001364225200000X
TX2074749225200000X
MNA1512225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant