Provider Demographics
NPI:1063533586
Name:LOWERY, CYNTHIA LYNN (PT)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LYNN
Last Name:LOWERY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 RACCOON VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-9470
Mailing Address - Country:US
Mailing Address - Phone:740-587-0440
Mailing Address - Fax:
Practice Address - Street 1:1450 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1825
Practice Address - Country:US
Practice Address - Phone:740-344-9465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6825225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist