Provider Demographics
NPI:1760610877
Name:LOWRY, JOE MICHEAL (COTA/L)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:MICHEAL
Last Name:LOWRY
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4240 LAKELAND HIGHLANDS RD
Mailing Address - Street 2:6310 CHRISTINA GROVE CIRCLE EAST
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3113
Mailing Address - Country:US
Mailing Address - Phone:863-607-5940
Mailing Address - Fax:863-644-4240
Practice Address - Street 1:4240 LAKELAND HIGHLANDS RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3113
Practice Address - Country:US
Practice Address - Phone:863-607-5841
Practice Address - Fax:863-644-4202
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-26
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCOTA/L9763225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology