Healthcare Provider Details

I. General information

NPI: 1902888456
Provider Name (Legal Business Name): CLAYTON DAVID LOWE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 02/13/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12304 N MAY AVE
OKLAHOMA CITY OK
73120-1944
US

IV. Provider business mailing address

12304 N. MAY AVE
WINTERSET OK
50273
US

V. Phone/Fax

Practice location:
  • Phone: 405-669-3415
  • Fax:
Mailing address:
  • Phone: 405-669-3415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4623
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberA06193
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: