Provider Demographics
NPI:1265853311
Name:VICKY J. LOWRANCE, D.C.
Entity Type:Organization
Organization Name:VICKY J. LOWRANCE, D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOWRANCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:719-544-7737
Mailing Address - Street 1:2025 N NORWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-5667
Mailing Address - Country:US
Mailing Address - Phone:719-544-7737
Mailing Address - Fax:719-544-7519
Practice Address - Street 1:2025 N NORWOOD AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-5667
Practice Address - Country:US
Practice Address - Phone:719-544-7737
Practice Address - Fax:719-544-7519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2035261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center