Provider Demographics
NPI:1194904045
Name:KAVAN, LOWELL FRANCIS (DC)
Entity type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:FRANCIS
Last Name:KAVAN
Suffix:
Gender:M
Credentials:DC
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Other - Credentials:
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:KAVAN CHIROPRACTIC 109 EAST 2ND ST
Mailing Address - City:WINTHROP
Mailing Address - State:MN
Mailing Address - Zip Code:55396-0206
Mailing Address - Country:US
Mailing Address - Phone:507-647-3257
Mailing Address - Fax:507-228-8091
Practice Address - Street 1:109 EAST 2ND ST
Practice Address - Street 2:KAVAN CHIROPRACTIC
Practice Address - City:WINTHROP
Practice Address - State:MN
Practice Address - Zip Code:55396-0206
Practice Address - Country:US
Practice Address - Phone:507-647-3257
Practice Address - Fax:507-228-8091
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2242111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN599227300Medicaid
MN359000105Medicare PIN