Provider Demographics
NPI:1902360647
Name:ROWING, JACEE
Entity Type:Individual
Prefix:
First Name:JACEE
Middle Name:
Last Name:ROWING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 TOWNSHIP ROAD 1278
Mailing Address - Street 2:
Mailing Address - City:PROCTORVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45669-8240
Mailing Address - Country:US
Mailing Address - Phone:304-479-3151
Mailing Address - Fax:
Practice Address - Street 1:335 TOWNSHIP ROAD 1026
Practice Address - Street 2:
Practice Address - City:SOUTH POINT
Practice Address - State:OH
Practice Address - Zip Code:45680-7842
Practice Address - Country:US
Practice Address - Phone:740-894-3476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV002145225200000X
OH010310225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant