Provider Demographics
NPI:1922656073
Name:LOWERY, KAITLIN N (PT)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:N
Last Name:LOWERY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14400 N BEL AIR DR SW
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-5860
Mailing Address - Country:US
Mailing Address - Phone:301-876-5636
Mailing Address - Fax:
Practice Address - Street 1:891 DORSEY HOTEL RD
Practice Address - Street 2:
Practice Address - City:GRANTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21536-1369
Practice Address - Country:US
Practice Address - Phone:301-895-5194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-02
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27914225100000X
WV004201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist