| Doctor Name: | MS. THERESA MARIE COWLES |
| NPI Number: | 1023411386 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.P.T |
| License Number: | 1723 |
| Business Practice Address: | 801 Broadway N Fargo, ND - 581023641 |
| Business Phone Number: | 7012345799 |
| Business Fax Number: | |
| Mailing Address: | 1814 14th St S Apt 3, FARGO |
| State: | ND |
| Postal Code: | 581034868 |
| Phone Number: | 7012345799 |
| Fax Number: | |
| NPI Enumeration Date: | 10/01/2014 |
| NPI Last Update Date: | 10/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 1723 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |