Healthcare Provider Details

I. General information

NPI: 1104632603
Provider Name (Legal Business Name): ANDREW LOWER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1169 SOUTHWIND DR
JUNCTION CITY KS
66441-2644
US

IV. Provider business mailing address

1169 SOUTHWIND DR
JUNCTION CITY KS
66441-2644
US

V. Phone/Fax

Practice location:
  • Phone: 620-640-7503
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-07186
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: