Individual
JOHN B FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
621 SCIENCE DR, COMPLIANCE MAIL CODE-2433, MADISON, WI 53711-1074
(608) 265-4025
(608) 265-8340
Mailing address
621 SCIENCE DR, COMPLIANCE MAIL CODE-2433, MADISON, WI 53711-1074
(608) 265-4025
(608) 265-8340
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
233-039
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
233-039
ATHLETIC TRAINER
WI
Enumeration date
07/21/2006
Last updated
07/08/2007
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