Provider Demographics
NPI:1891979555
Name:LOWRY FAMILY CHIROPRACTIC CLINIC, PA
Entity Type:Organization
Organization Name:LOWRY FAMILY CHIROPRACTIC CLINIC, PA
Other - Org Name:CAMDEN CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDEN
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-521-2261
Mailing Address - Street 1:4149 LYNDALE AVE N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55412-1703
Mailing Address - Country:US
Mailing Address - Phone:612-521-2261
Mailing Address - Fax:612-521-5200
Practice Address - Street 1:4149 LYNDALE AVE N
Practice Address - Street 2:SUITE 200
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55412-1703
Practice Address - Country:US
Practice Address - Phone:612-521-2261
Practice Address - Fax:612-521-5200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty