Provider Demographics
NPI:1063881563
Name:LOWIE, BRITT GALEN (LMT)
Entity type:Individual
Prefix:
First Name:BRITT
Middle Name:GALEN
Last Name:LOWIE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 PUCKETTS DR SW
Mailing Address - Street 2:APT A
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-5659
Mailing Address - Country:US
Mailing Address - Phone:678-427-3701
Mailing Address - Fax:
Practice Address - Street 1:5290 ROSWELL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1978
Practice Address - Country:US
Practice Address - Phone:678-427-3701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-15
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT007595225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist