Provider Demographics
NPI:1104081843
Name:LOWRY, KATHLEEN RYAN (LACDIPLAC(NCCAOM))
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:RYAN
Last Name:LOWRY
Suffix:
Gender:F
Credentials:LACDIPLAC(NCCAOM)
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:101 N PACIFIC COAST HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3149
Mailing Address - Country:US
Mailing Address - Phone:310-379-0559
Mailing Address - Fax:310-379-9678
Practice Address - Street 1:101 N PACIFIC COAST HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3149
Practice Address - Country:US
Practice Address - Phone:310-379-0559
Practice Address - Fax:310-379-9678
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC3405171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist