Individual
KYLE BOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
618 JACKSON ST, ROCKDALE, TX 76567-2216
(512) 429-1575
Mailing address
618 JACKSON ST, ROCKDALE, TX 76567-2216
(512) 429-1575
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2084702
TX
Other
Enumeration date
12/21/2014
Last updated
12/21/2014
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