Provider Demographics
NPI:1699439687
Name:LOWE, MEGAN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14101 FAIRVIEW DR STE 250
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-2523
Mailing Address - Country:US
Mailing Address - Phone:952-435-4190
Mailing Address - Fax:952-892-3372
Practice Address - Street 1:14101 FAIRVIEW DR STE 250
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-2523
Practice Address - Country:US
Practice Address - Phone:952-435-4190
Practice Address - Fax:952-892-3372
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15494225100000X
MN12619225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist