Provider Demographics
NPI:1700289139
Name:LOW, BRIAN (DPT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:LOW
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 WESTGATE CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8396
Mailing Address - Country:US
Mailing Address - Phone:615-678-0024
Mailing Address - Fax:615-610-6331
Practice Address - Street 1:1605 WESTGATE CIR STE 100
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8396
Practice Address - Country:US
Practice Address - Phone:615-678-0024
Practice Address - Fax:615-610-6331
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208912225100000X
TN10599225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist