Provider Demographics
NPI:1851516033
Name:FOWLER, DELINDA ANN (PTA)
Entity Type:Individual
Prefix:MS
First Name:DELINDA
Middle Name:ANN
Last Name:FOWLER
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 1:107 FRANKLIN ST
Mailing Address - Street 2:APT B
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-3975
Mailing Address - Country:US
Mailing Address - Phone:617-930-1411
Mailing Address - Fax:
Practice Address - Street 1:107 FRANKLIN ST
Practice Address - Street 2:APT B
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-3975
Practice Address - Country:US
Practice Address - Phone:617-930-1411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant