Provider Demographics
NPI:1013619659
Name:LOWDER, DYLAN DAY (DC)
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:DAY
Last Name:LOWDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71368 SAINT MARY ST
Mailing Address - Street 2:
Mailing Address - City:ABITA SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70420-3702
Mailing Address - Country:US
Mailing Address - Phone:985-773-2051
Mailing Address - Fax:
Practice Address - Street 1:7015 HIGHWAY 190 EAST SERVICE RD STE 201
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-4960
Practice Address - Country:US
Practice Address - Phone:985-893-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1976111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor