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General NPI Number Information
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NPI Number | 1336748680
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Entity Type | Individual
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Provider Name | KELSEY LOWE LPTA
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Gender | Female
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Dates
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Enumeration Date | 10/19/2020
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 290 SGT PRENTISS DR STE A
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City | NATCHEZ
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State | MS
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Zip | 39120-4142
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Country | US
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Telephone | 601-600-2515
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Fax |
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Provider Business Mailing Address
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Address Line | 20 OAKWOOD LN
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City | NATCHEZ
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State | MS
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Zip | 39120-5036
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA6953
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License Number State | MS
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