Provider Demographics
NPI:1588724967
Name:LOWE, TERESA (DC)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:T
Other - Middle Name:SAMMI
Other - Last Name:LOWE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:6000 E EVANS AVE
Mailing Address - Street 2:3 011
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222
Mailing Address - Country:US
Mailing Address - Phone:303-691-9922
Mailing Address - Fax:303-691-9944
Practice Address - Street 1:6000 E EVANS AVE
Practice Address - Street 2:3 011
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222
Practice Address - Country:US
Practice Address - Phone:303-691-9922
Practice Address - Fax:303-691-9944
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1646111N00000X
WY312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T67859Medicare UPIN
COC46863Medicare ID - Type Unspecified