Provider Demographics
NPI:1972562825
Name:LOWE CHIROPRACTIC CLINIC, PC
Entity type:Organization
Organization Name:LOWE CHIROPRACTIC CLINIC, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:D
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-468-0520
Mailing Address - Street 1:12304 N MAY AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-1944
Mailing Address - Country:US
Mailing Address - Phone:405-669-3415
Mailing Address - Fax:405-967-6116
Practice Address - Street 1:12304 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-1944
Practice Address - Country:US
Practice Address - Phone:405-669-3415
Practice Address - Fax:405-967-6116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1229393Medicaid
IA48282OtherBC/BS
IA48282OtherBC/BS
U73863Medicare UPIN