Provider Demographics
NPI:1457431009
Name:LOW, MICHAEL ELIOT (PT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ELIOT
Last Name:LOW
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3458 CASTLE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-7354
Mailing Address - Country:US
Mailing Address - Phone:916-441-7471
Mailing Address - Fax:916-441-7474
Practice Address - Street 1:2231 J ST
Practice Address - Street 2:SUITE 107
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4743
Practice Address - Country:US
Practice Address - Phone:916-441-7471
Practice Address - Fax:916-441-7471
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 14031225100000X, 2251S0007X
CAPT140312251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT140310OtherBLUE SHIELD
CA0PT140310OtherBLUE SHIELD