Provider Demographics
NPI:1710770565
Name:LOWE, SHELBY GRACE (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:GRACE
Last Name:LOWE
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 STONEHURST DR
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-7041
Mailing Address - Country:US
Mailing Address - Phone:704-798-3307
Mailing Address - Fax:
Practice Address - Street 1:171 MOULTRIE ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29409-0001
Practice Address - Country:US
Practice Address - Phone:704-798-3307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1209207PS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine