Provider Demographics
NPI:1649652900
Name:ROWIN, BOB (AAS-HIS)
Entity type:Individual
Prefix:
First Name:BOB
Middle Name:
Last Name:ROWIN
Suffix:
Gender:M
Credentials:AAS-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E FLORENCE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-4672
Mailing Address - Country:US
Mailing Address - Phone:520-836-6994
Mailing Address - Fax:
Practice Address - Street 1:801 E FLORENCE BLVD STE A
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-4672
Practice Address - Country:US
Practice Address - Phone:520-836-6994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-23
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1093237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist