Organization
FOWLER ENTERPRISES, INC.
Active
Other names
East Mountain Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL W FOWLER PT (OWNER/ AUTHORIZED REPRESENTATIVE)
(505) 220-6949
Entity
Organization
Contact information
Practice address
1851-2B OLD HIGHWAY 66, EDGEWOOD, NM 87015
(505) 281-8463
Mailing address
PO BOX 1730, MORIARTY, NM 87035-1730
(505) 281-8463
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08028079
—
NM
Enumeration date
11/30/2007
Last updated
12/22/2011
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