Provider Demographics
NPI:1578642583
Name:TREVOR LOWRY CHIROPRACTIC
Entity Type:Organization
Organization Name:TREVOR LOWRY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:LOWRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-521-0471
Mailing Address - Street 1:1104 ASHTON AVE
Mailing Address - Street 2:STE. 203
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-4504
Mailing Address - Country:US
Mailing Address - Phone:801-521-0471
Mailing Address - Fax:
Practice Address - Street 1:1104 ASHTON AVE
Practice Address - Street 2:STE. 203
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-4504
Practice Address - Country:US
Practice Address - Phone:801-521-0471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6263125-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty