Provider Demographics
NPI:1972116473
Name:ROWE, JAMES BRADLEY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BRADLEY
Last Name:ROWE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1991 FORDHAM DR STE 102
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3774
Mailing Address - Country:US
Mailing Address - Phone:910-484-4653
Mailing Address - Fax:910-483-9256
Practice Address - Street 1:1639 BRADLEY PARK DR STE C-2
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-3620
Practice Address - Country:US
Practice Address - Phone:706-322-9311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5932225100000X
GAPT014770225100000X
NCP-CP011266T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist