Provider Demographics
NPI:1780612069
Name:YARBROUGH, LOWELL PAUL
Entity type:Individual
Prefix:
First Name:LOWELL
Middle Name:PAUL
Last Name:YARBROUGH
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 1:1856 CONVERSE AVE
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-5050
Mailing Address - Country:US
Mailing Address - Phone:307-635-3800
Mailing Address - Fax:307-635-3801
Practice Address - Street 1:1856 CONVERSE AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-5050
Practice Address - Country:US
Practice Address - Phone:307-635-3800
Practice Address - Fax:307-635-3801
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor