Provider Demographics
NPI:1720451909
Name:PAWLITZ, DAWN
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:PAWLITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2883 BRINKMAN RD
Mailing Address - Street 2:
Mailing Address - City:OWENSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65066-2118
Mailing Address - Country:US
Mailing Address - Phone:314-517-9747
Mailing Address - Fax:
Practice Address - Street 1:2883 BRINKMAN RD
Practice Address - Street 2:
Practice Address - City:OWENSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65066-2118
Practice Address - Country:US
Practice Address - Phone:314-517-9747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-10
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015036905225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant