Healthcare Provider Details

I. General information

NPI: 1073987467
Provider Name (Legal Business Name): JO LOWE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2015
Last Update Date: 11/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S. LAWTON AVE. APT 315
TULSA OK
74127
US

IV. Provider business mailing address

420 S. LAWTON AVE. APT 315
TULSA OK
74127
US

V. Phone/Fax

Practice location:
  • Phone: 918-277-2356
  • Fax:
Mailing address:
  • Phone: 918-277-2356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: