Provider Demographics
NPI:1083764344
Name:LOWE, REBECCA CAMILLE (LPTA)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:CAMILLE
Last Name:LOWE
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3748 RATCLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219-4350
Mailing Address - Country:US
Mailing Address - Phone:276-679-7408
Mailing Address - Fax:
Practice Address - Street 1:295 WHARTON LN NE
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1541
Practice Address - Country:US
Practice Address - Phone:276-679-7409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306601409225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant