Provider Demographics
NPI:1225687411
Name:COWLES, JESSICA MILLS
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MILLS
Last Name:COWLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 BARRETT LAKES BLVD NW APT 501
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-8000
Mailing Address - Country:US
Mailing Address - Phone:901-692-7884
Mailing Address - Fax:
Practice Address - Street 1:1900 W POPLAR AVE
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-0605
Practice Address - Country:US
Practice Address - Phone:901-759-5491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist