Provider Demographics
NPI:1851333934
Name:ROWE, TAMATHA SUZANNE (DC)
Entity Type:Individual
Prefix:MISS
First Name:TAMATHA
Middle Name:SUZANNE
Last Name:ROWE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9616 N MAY AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-2714
Mailing Address - Country:US
Mailing Address - Phone:405-749-2225
Mailing Address - Fax:405-748-6196
Practice Address - Street 1:9616 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-2714
Practice Address - Country:US
Practice Address - Phone:405-749-2225
Practice Address - Fax:405-748-6196
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3348111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU65942Medicare UPIN