Provider Demographics
NPI:1881304962
Name:FOWLER, LEXI LEE
Entity type:Individual
Prefix:MISS
First Name:LEXI
Middle Name:LEE
Last Name:FOWLER
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 1:117 SHERATON LOOP
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29341-4422
Mailing Address - Country:US
Mailing Address - Phone:864-492-8867
Mailing Address - Fax:
Practice Address - Street 1:117 SHERATON LOOP
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29341-4422
Practice Address - Country:US
Practice Address - Phone:864-492-8867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer