Provider Demographics
NPI:1922364058
Name:FOWLER, AMY R (DPT, CLT)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:R
Last Name:FOWLER
Suffix:
Gender:F
Credentials:DPT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 FAUNCE CORNER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1221
Mailing Address - Country:US
Mailing Address - Phone:508-984-7226
Mailing Address - Fax:508-984-7212
Practice Address - Street 1:250 FAUNCE CORNER RD
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1221
Practice Address - Country:US
Practice Address - Phone:508-984-7226
Practice Address - Fax:508-984-7212
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19242225100000X
MEPT3768225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist