Provider Demographics
NPI:1902047830
Name:LOWE, DANIEL CARSON (LMT, MMP)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:CARSON
Last Name:LOWE
Suffix:
Gender:M
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 FOX CHAPEL DR
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-8372
Mailing Address - Country:US
Mailing Address - Phone:803-407-7928
Mailing Address - Fax:
Practice Address - Street 1:109 FOX CHAPEL DR
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-8372
Practice Address - Country:US
Practice Address - Phone:803-407-7928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1947225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist