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General NPI Number Information
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NPI Number | 1598587206
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Entity Type | Individual
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Provider Name | MANNIE LOWERY JR. DC
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Gender | Male
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 2245 GODBY RD
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City | COLLEGE PARK
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State | GA
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Zip | 30349-5059
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Country | US
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Telephone | 770-990-4560
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Fax | 770-216-1626
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Provider Business Mailing Address
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Address Line | 2245 GODBY RD STE 120
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City | COLLEGE PARK
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State | GA
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Zip | 30349-5060
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Country | US
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Telephone | 770-990-4560
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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 | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number | CHIR011149
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License Number State | GA
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