Provider Demographics
NPI:1578886420
Name:LOWRY, BETHANY DIANE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:DIANE
Last Name:LOWRY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DUNN LN
Mailing Address - Street 2:
Mailing Address - City:LEOMA
Mailing Address - State:TN
Mailing Address - Zip Code:38468-5235
Mailing Address - Country:US
Mailing Address - Phone:423-915-6640
Mailing Address - Fax:
Practice Address - Street 1:993 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-4432
Practice Address - Country:US
Practice Address - Phone:931-363-3572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-07
Last Update Date:2010-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8572225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist