Provider Demographics
NPI:1154548238
Name:LOWRY, ROY CRAIG (ATC, LAT)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:CRAIG
Last Name:LOWRY
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4417 DALNY ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-2308
Mailing Address - Country:US
Mailing Address - Phone:515-564-8735
Mailing Address - Fax:515-564-8736
Practice Address - Street 1:833 5TH AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1306
Practice Address - Country:US
Practice Address - Phone:515-564-8735
Practice Address - Fax:515-564-8736
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT11002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer