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1982096137
IRA EDWARD FOWLER
BUCKHANNON, WV
NPI
1982096137
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: 2000012772)
Enumeration Date
2015-02-25
Last Update Date
2015-02-25
Business Address
Mr. IRA EDWARD FOWLER ATC
59 COLLEGE AVE
BUCKHANNON, WV 26201-2600
Phone number: 304-473-8349
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Mailing Address
Mr. IRA EDWARD FOWLER ATC
180A JONES RD
WHEELERSBURG, OH 45694
Phone number: 740-961-7461
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