Provider Demographics
NPI:1336501519
Name:LOWRIE, SANDRA (LMT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:LOWRIE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9138 ARLON ST STE A3-960
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-3876
Mailing Address - Country:US
Mailing Address - Phone:907-748-6530
Mailing Address - Fax:
Practice Address - Street 1:9138 ARLON ST STE A3-960
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-3876
Practice Address - Country:US
Practice Address - Phone:907-748-6530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK108418225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist