Provider Demographics
NPI:1891676433
Name:DOW, BRENT
Entity type:Individual
Prefix:
First Name:BRENT
Middle Name:
Last Name:DOW
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 1:2000 CHAPEL VIEW BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-3087
Mailing Address - Country:US
Mailing Address - Phone:401-533-9631
Mailing Address - Fax:
Practice Address - Street 1:2000 CHAPEL VIEW BLVD STE 140
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-3087
Practice Address - Country:US
Practice Address - Phone:401-533-9631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPTA01529225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant