Provider Demographics
NPI:1336875947
Name:ROWE, MICHAELA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:ROWE
Suffix:
Gender:F
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 1:5500 MOUNTAIN VISTA ST APT 1521
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-4235
Mailing Address - Country:US
Mailing Address - Phone:530-312-0189
Mailing Address - Fax:
Practice Address - Street 1:3777 PECOS-MCLEOD INTERCONNECT
Practice Address - Street 2:SUITE 102
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120
Practice Address - Country:US
Practice Address - Phone:725-205-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist