Basic Information
| Provider Information | |||||||||
| NPI: | 1295144202 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FOWLER | ||||||||
| FirstName: | RHONDA | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7404 EXECUTIVE PL | ||||||||
| Address2: | #300B | ||||||||
| City: | LANHAM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207062268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015999500 | ||||||||
| FaxNumber: | 3018567685 | ||||||||
| Practice Location | |||||||||
| Address1: | 7501 SURRATTS RD | ||||||||
| Address2: | 301 | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207353362 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2408421435 | ||||||||
| FaxNumber: | 3018685443 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2014 | ||||||||
| LastUpdateDate: | 08/05/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 19575 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.