Individual
THEODORE COWLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
400 S ORANGE AVE, SOUTH ORANGE, NJ 07079-2646
(973) 275-2510
Mailing address
1287 KENNEDY RD, STREETSBORO, OH 44241-5848
(330) 819-0279
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00200400
NJ
Other
Enumeration date
12/04/2015
Last updated
12/04/2015
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