Individual
MRS. STACEY P FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LAT, ATC, LMBT
Contact information
Practice address
1700 WOODRIDGE CIR, HICKORY, NC 28602-5599
(704) 408-2318
Mailing address
1700 WOODRIDGE CIR, HICKORY, NC 28602-5599
(704) 408-2318
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
333921
NC
2255A2300X
Athletic Trainer
0823
NC
225700000X
Massage Therapist
0417
NC
Other
Enumeration date
03/29/2006
Last updated
03/08/2024
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