Provider Demographics
NPI:1992159131
Name:LOW, ANDREA SUSANNE (DPT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:SUSANNE
Last Name:LOW
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:SUSANNE
Other - Last Name:WEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:101 3RD AVE SW STE 102
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-5736
Mailing Address - Country:US
Mailing Address - Phone:319-200-6102
Mailing Address - Fax:319-200-6104
Practice Address - Street 1:101 3RD AVE SW STE 102
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-5736
Practice Address - Country:US
Practice Address - Phone:319-200-6102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13431225100000X
390200000X
IA087862225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program