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General NPI Number Information
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NPI Number | 1003497314
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Entity Type | Individual
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Provider Name | DEMARR LOWE THOMAS LMT, CMLDT, MMP
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Gender | Male
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 2150 N MAIN ST
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City | BELTON
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State | TX
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Zip | 76513-1919
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Country | US
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Telephone | 254-613-5656
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Fax |
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Provider Business Mailing Address
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Address Line | 2206 BASALT DR
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City | KILLEEN
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State | TX
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Zip | 76549-4904
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Country | US
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Telephone | 254-220-6763
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT134683
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License Number State | TX
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