Provider Demographics
NPI:1558734582
Name:LOW, WILY (DC)
Entity Type:Individual
Prefix:MR
First Name:WILY
Middle Name:
Last Name:LOW
Suffix:
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 1:3401 E BENSON HWY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85706-1807
Mailing Address - Country:US
Mailing Address - Phone:520-889-7168
Mailing Address - Fax:
Practice Address - Street 1:3401 E BENSON HWY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85706-1807
Practice Address - Country:US
Practice Address - Phone:520-889-7168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor