Provider Demographics
NPI:1477972420
Name:LOWRY, PAUL (ATC, MED)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:LOWRY
Suffix:
Gender:M
Credentials:ATC, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 S COLLEGE AVE
Mailing Address - Street 2:BOB CARPENTER CENTER
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19716-2010
Mailing Address - Country:US
Mailing Address - Phone:302-831-2256
Mailing Address - Fax:302-831-8653
Practice Address - Street 1:631 S COLLEGE AVE
Practice Address - Street 2:BOB CARPENTER CENTER
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19716-2010
Practice Address - Country:US
Practice Address - Phone:302-831-2256
Practice Address - Fax:302-831-8653
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ3-00004912255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer