Provider Demographics
NPI:1831071257
Name:FOWLER PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:FOWLER PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:MELODY PALLAS
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:303-418-8674
Mailing Address - Street 1:1082 GARRISON ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-4728
Mailing Address - Country:US
Mailing Address - Phone:720-334-4514
Mailing Address - Fax:
Practice Address - Street 1:10105 W 26TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80215-6653
Practice Address - Country:US
Practice Address - Phone:303-418-8674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy