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General NPI Number Information
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NPI Number | 1093912313
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Entity Type | Individual
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Provider Name | JOHN RUSSELL LOWE MPT, MAT, LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4642 N LOOP 289 STE 205
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City | LUBBOCK
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State | TX
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Zip | 79416-2424
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Country | US
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Telephone | 806-775-9275
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Fax |
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Provider Business Mailing Address
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Address Line | 4206 49TH ST
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City | LUBBOCK
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State | TX
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Zip | 79413-3722
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Country | US
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Telephone | 806-241-5328
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1151247
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT2026
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License Number State | TX
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