Provider Demographics
NPI:1558761064
Name:KANTZER, LOWELL DEAN (DPT)
Entity Type:Individual
Prefix:
First Name:LOWELL
Middle Name:DEAN
Last Name:KANTZER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 OAK FARM DR
Mailing Address - Street 2:2104
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-1506
Mailing Address - Country:US
Mailing Address - Phone:508-954-5606
Mailing Address - Fax:
Practice Address - Street 1:5901 MACARTHUR BLVD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2541
Practice Address - Country:US
Practice Address - Phone:202-349-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011571225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist