Provider Demographics
NPI:1194856088
Name:LOWERY, DAVID P (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:P
Last Name:LOWERY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 E CRESTLINE DR
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-2406
Mailing Address - Country:US
Mailing Address - Phone:406-570-3770
Mailing Address - Fax:
Practice Address - Street 1:1003 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4971
Practice Address - Country:US
Practice Address - Phone:406-549-3163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3276183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist