Provider Demographics
NPI:1336225614
Name:SOWELL, SCOTT E (ATC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:E
Last Name:SOWELL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39600 JOLINE AVE
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-2983
Mailing Address - Country:US
Mailing Address - Phone:661-947-3736
Mailing Address - Fax:
Practice Address - Street 1:14048 COBALT RD
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-9316
Practice Address - Country:US
Practice Address - Phone:760-955-3353
Practice Address - Fax:760-955-3473
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer