Provider Demographics
NPI:1780833947
Name:ROWE, MILES EDWARD (LAC)
Entity Type:Individual
Prefix:
First Name:MILES
Middle Name:EDWARD
Last Name:ROWE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 KELLOM CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-2331
Mailing Address - Country:US
Mailing Address - Phone:919-794-5252
Mailing Address - Fax:
Practice Address - Street 1:7 KELLOM CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-2331
Practice Address - Country:US
Practice Address - Phone:919-794-5252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC507171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist