Provider Demographics
NPI:1518232123
Name:LOWE, ERICA RENEE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:RENEE
Last Name:LOWE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 W 6TH ST STE 111
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1823
Mailing Address - Country:US
Mailing Address - Phone:213-607-4400
Mailing Address - Fax:213-250-7245
Practice Address - Street 1:1111 W 6TH ST STE 111
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1823
Practice Address - Country:US
Practice Address - Phone:213-607-4400
Practice Address - Fax:213-250-7245
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA376752251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics