Provider Demographics
NPI:1881838167
Name:CHOWN, MARY VERONICA (PT, OT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:VERONICA
Last Name:CHOWN
Suffix:
Gender:F
Credentials:PT, OT
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:VERONICA
Other - Last Name:HEFFRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:37 CEDAR SPRINGS RD
Mailing Address - Street 2:LOT 15
Mailing Address - City:MOUNT IDA
Mailing Address - State:AR
Mailing Address - Zip Code:71957-8154
Mailing Address - Country:US
Mailing Address - Phone:713-213-9194
Mailing Address - Fax:
Practice Address - Street 1:407 CARSON ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6852
Practice Address - Country:US
Practice Address - Phone:501-624-6468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3068225100000X
TX1149608225100000X
AR2255225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist