Provider Demographics
NPI:1104837848
Name:LOWRY, TREVOR ALLAN (DC)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:ALLAN
Last Name:LOWRY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 ASHTON AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-4504
Mailing Address - Country:US
Mailing Address - Phone:801-521-0471
Mailing Address - Fax:
Practice Address - Street 1:1104 ASHTON AVE
Practice Address - Street 2:STE 203
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-4504
Practice Address - Country:US
Practice Address - Phone:801-521-0471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6263125-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor