Provider Demographics
NPI:1689383689
Name:MOWREY, AUSTIN M (PT, DPT)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:M
Last Name:MOWREY
Suffix:
Gender:M
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 1:9110 PHILADELPHIA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4323
Mailing Address - Country:US
Mailing Address - Phone:410-574-4966
Mailing Address - Fax:
Practice Address - Street 1:200 W COLD SPRING LN STE 300
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2831
Practice Address - Country:US
Practice Address - Phone:410-662-7977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29234225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist