Provider Demographics
NPI:1700075215
Name:LOWRANCE, DAVID E (MS, LLP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:LOWRANCE
Suffix:
Gender:M
Credentials:MS, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 N EVANS ST
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286-1554
Mailing Address - Country:US
Mailing Address - Phone:517-673-3274
Mailing Address - Fax:517-264-0383
Practice Address - Street 1:127 N EVANS ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-1554
Practice Address - Country:US
Practice Address - Phone:517-673-3274
Practice Address - Fax:517-264-0383
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-21
Last Update Date:2007-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009890103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical