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NPI Code Detail

MEDICARE: SUSAN LOWERY FAIR PT

MEDICARE:   SUSAN LOWERY FAIR  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist598SC

General Provider Information

NPI Number : 1235272576
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN LOWERY FAIR PT
Provider Business Mailing Address
First Line : 1 MALLARD CT
Second Line :
City : GREENVILLE
State : SC
Zip : 29617-6139
Country : US
Telephone Number : 864-294-1718
Fax Number :
Provider Business Practice Location Address
First Line : 3300 POINSETT HWY
Second Line : FURMAN UNIVERSITY SPORTS MEDICINE CENTER
City : GREENVILLE
State : SC
Zip : 29613-0002
Country : US
Telephone Number : 864-294-2130
Fax Number : 864-294-3590
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2007
Last Update Date : 07/08/2007

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Directions to “ SUSAN LOWERY FAIR PT” Practice Location

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