Provider Demographics
NPI:1548266984
Name:LOWERY, DARA S (RPT)
Entity type:Individual
Prefix:MRS
First Name:DARA
Middle Name:S
Last Name:LOWERY
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO DRAWER 1200
Mailing Address - Street 2:110 BAKER AVE
Mailing Address - City:CLANTON
Mailing Address - State:AL
Mailing Address - Zip Code:35046-1200
Mailing Address - Country:US
Mailing Address - Phone:205-280-6450
Mailing Address - Fax:205-280-6451
Practice Address - Street 1:110 BAKER AVE
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045-2337
Practice Address - Country:US
Practice Address - Phone:205-280-6450
Practice Address - Fax:205-280-6451
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4482225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51525716OtherBCBS
AL51525716OtherBCBS