Provider Demographics
NPI:1548807746
Name:COWLES, NOAH GLENN
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:GLENN
Last Name:COWLES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 PITTSBURGH RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-2027
Mailing Address - Country:US
Mailing Address - Phone:814-493-5138
Mailing Address - Fax:
Practice Address - Street 1:1404 PITTSBURGH RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-2027
Practice Address - Country:US
Practice Address - Phone:814-493-5138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer