Provider Demographics
NPI:1902549082
Name:LOWNEY, BRENDON MICHAEL
Entity Type:Individual
Prefix:
First Name:BRENDON
Middle Name:MICHAEL
Last Name:LOWNEY
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 1:302 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1606
Mailing Address - Country:US
Mailing Address - Phone:218-722-4745
Mailing Address - Fax:
Practice Address - Street 1:302 W 1ST ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1606
Practice Address - Country:US
Practice Address - Phone:218-722-4745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator