Provider Demographics
NPI:1982134300
Name:LOWENTHAL, LORIE GREENBERG (PTA)
Entity Type:Individual
Prefix:
First Name:LORIE
Middle Name:GREENBERG
Last Name:LOWENTHAL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1453 S EUDORA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3527
Mailing Address - Country:US
Mailing Address - Phone:303-246-7644
Mailing Address - Fax:
Practice Address - Street 1:1453 S EUDORA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3527
Practice Address - Country:US
Practice Address - Phone:303-246-7644
Practice Address - Fax:303-246-7644
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013992225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant