Provider Demographics
NPI:1619123221
Name:LOWERY, JOSHUA SHANE (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:SHANE
Last Name:LOWERY
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 1:316 OVERLOOK TRL
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-1494
Mailing Address - Country:US
Mailing Address - Phone:678-363-0007
Mailing Address - Fax:
Practice Address - Street 1:316 OVERLOOK TRL
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-1494
Practice Address - Country:US
Practice Address - Phone:678-363-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008373111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor