Provider Demographics
NPI:1558407320
Name:LOWRY, THOMAS WILLIAMS JR (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WILLIAMS
Last Name:LOWRY
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-1210
Mailing Address - Country:US
Mailing Address - Phone:248-435-2282
Mailing Address - Fax:248-435-3526
Practice Address - Street 1:1311 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-1210
Practice Address - Country:US
Practice Address - Phone:248-435-2282
Practice Address - Fax:248-435-3526
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005514111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
625885Medicare ID - Type Unspecified
F35345Medicare UPIN