Provider Demographics
NPI:1396106407
Name:LOWRY, PHILLIP (BC-HIS)
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:
Last Name:LOWRY
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 N WALDRON ST STE 115
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1192
Mailing Address - Country:US
Mailing Address - Phone:620-669-7752
Mailing Address - Fax:
Practice Address - Street 1:2020 N WALDRON ST STE 115
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1192
Practice Address - Country:US
Practice Address - Phone:620-669-7752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS590174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist