Provider Demographics
NPI:1043325608
Name:LOWREY, AMY RENNEE (LMT)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:RENNEE
Last Name:LOWREY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 TRAVIS ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-3298
Mailing Address - Country:US
Mailing Address - Phone:318-425-5000
Mailing Address - Fax:
Practice Address - Street 1:220 TRAVIS ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-3298
Practice Address - Country:US
Practice Address - Phone:318-424-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA2501174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist