Provider Demographics
NPI:1417049933
Name:LOWRY, SHAUNA NICHELE
Entity Type:Individual
Prefix:MS
First Name:SHAUNA
Middle Name:NICHELE
Last Name:LOWRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16200 COLEEN ST
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92337
Mailing Address - Country:US
Mailing Address - Phone:323-793-1842
Mailing Address - Fax:909-355-1826
Practice Address - Street 1:16200 COLEEN ST
Practice Address - Street 2:SUITE A
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92337
Practice Address - Country:US
Practice Address - Phone:323-793-1842
Practice Address - Fax:909-355-1826
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies