Provider Demographics
NPI:1942403647
Name:LOWRIMORE, JONI NICOLE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:JONI
Middle Name:NICOLE
Last Name:LOWRIMORE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:JONI
Other - Middle Name:NICOLE
Other - Last Name:SENTERFEIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2720 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PELION
Mailing Address - State:SC
Mailing Address - Zip Code:29123-9573
Mailing Address - Country:US
Mailing Address - Phone:803-518-2803
Mailing Address - Fax:
Practice Address - Street 1:7601 PARKLANE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6122
Practice Address - Country:US
Practice Address - Phone:803-741-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2098225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant