Provider Demographics
NPI:1457867657
Name:WEBER, LOWELL E (HCP)
Entity Type:Individual
Prefix:
First Name:LOWELL
Middle Name:E
Last Name:WEBER
Suffix:
Gender:M
Credentials:HCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5180 WEST 700 SOUTH
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47334
Mailing Address - Country:US
Mailing Address - Phone:765-744-7830
Mailing Address - Fax:
Practice Address - Street 1:4714 S SCATTERFIELD RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-2908
Practice Address - Country:US
Practice Address - Phone:765-629-2222
Practice Address - Fax:765-649-0899
Is Sole Proprietor?:No
Enumeration Date:2017-12-26
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001216A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist