Provider Demographics
NPI:1295716801
Name:LOWRY, CARINA (PT)
Entity type:Individual
Prefix:
First Name:CARINA
Middle Name:
Last Name:LOWRY
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 1:1262 TAYLOR AVE W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-1448
Mailing Address - Country:US
Mailing Address - Phone:978-606-8565
Mailing Address - Fax:
Practice Address - Street 1:514 SAINT PETER ST STE 210
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-1066
Practice Address - Country:US
Practice Address - Phone:651-209-6144
Practice Address - Fax:651-209-6145
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7738225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist