Provider Demographics
NPI:1184650020
Name:PACKER-LOWE, RENEE (RPT)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:PACKER-LOWE
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25620 WYNDHAM POINT CT
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105
Mailing Address - Country:US
Mailing Address - Phone:703-489-6299
Mailing Address - Fax:703-935-8710
Practice Address - Street 1:25620 WYNDHAM POINT CT
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-2694
Practice Address - Country:US
Practice Address - Phone:703-489-6299
Practice Address - Fax:703-935-8710
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23050060162251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics