Provider Demographics
NPI:1528512084
Name:JONES-BOWLES, KELLIE (PT, DPT, PCS)
Entity type:Individual
Prefix:DR
First Name:KELLIE
Middle Name:
Last Name:JONES-BOWLES
Suffix:
Gender:F
Credentials:PT, DPT, PCS
Other - Prefix:DR
Other - First Name:KELLIE
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, PCS
Mailing Address - Street 1:145 WESTPORT RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612-1329
Mailing Address - Country:US
Mailing Address - Phone:518-522-7637
Mailing Address - Fax:
Practice Address - Street 1:55 WASHINGTON STREET
Practice Address - Street 2:SUITE 502
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854
Practice Address - Country:US
Practice Address - Phone:888-355-3255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT96882251P0200X
NY035248-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics