Individual
LORI FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
538 MENGE AVE, PASS CHRISTIAN, MS 39571-4234
(228) 452-4344
Mailing address
538 MENGE AVE, PASS CHRISTIAN, MS 39571-4234
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3397
MS
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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