MEDICARE: DR. LOWELL WILLIAM BRAGG D.C.

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
1	111N00000X	Chiropractor	2172	AL

General Provider Information

NPI Number	:	1487759056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOWELL WILLIAM BRAGG D.C.

Provider Business Mailing Address
First Line	:	4541 MAGNOLIA DRIVE
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242
Country	:	US
Telephone Number	:	205-821-2849
Fax Number	:	205-933-5172

Provider Business Practice Location Address
First Line	:	1318 20TH STREET SOUTH
Second Line	:	SUITE 100
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205
Country	:	US
Telephone Number	:	205-933-5604
Fax Number	:	205-933-5172

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	07/08/2007

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