Basic Information
| Provider Information | |||||||||
| NPI: | 1750712279 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SOWLE | ||||||||
| FirstName: | NATHAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1619 BARBARA ANN CIR | ||||||||
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| City: | KANNAPOLIS | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280836574 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043157373 | ||||||||
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| Practice Location | |||||||||
| Address1: | 920 CHURCH ST N | ||||||||
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| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280252927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044033000 | ||||||||
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| ProviderEnumerationDate: | 12/09/2013 | ||||||||
| LastUpdateDate: | 12/09/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | 1193 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.