Provider Demographics
NPI:1679233399
Name:STOWE, CONNOR HARRIS (PT, DPT)
Entity type:Individual
Prefix:
First Name:CONNOR
Middle Name:HARRIS
Last Name:STOWE
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1243 SHERMAN DR STE 100F
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-6170
Mailing Address - Country:US
Mailing Address - Phone:303-228-7782
Mailing Address - Fax:
Practice Address - Street 1:1243 SHERMAN DR STE 100F
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6170
Practice Address - Country:US
Practice Address - Phone:303-228-7782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0018092225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist