Provider Demographics
NPI:1255731717
Name:LOWER, NATHAN
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:
Last Name:LOWER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 W 3100 S
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-9779
Mailing Address - Country:US
Mailing Address - Phone:801-645-5995
Mailing Address - Fax:
Practice Address - Street 1:1435 VILLAGE DR DEPT 2810
Practice Address - Street 2:WEBER STATE UNIVERSITY
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84408-2801
Practice Address - Country:US
Practice Address - Phone:801-645-5995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer