Provider Demographics
NPI:1255548012
Name:ROWE, ROBERT HOWARD (PT)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HOWARD
Last Name:ROWE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BRIARCREEK RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-5310
Mailing Address - Country:US
Mailing Address - Phone:904-646-4668
Mailing Address - Fax:
Practice Address - Street 1:3901 UNIVERSITY BLVD S
Practice Address - Street 2:SUITE 137
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4312
Practice Address - Country:US
Practice Address - Phone:904-858-7317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT 647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist