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General NPI Number Information
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NPI Number | 1770731796
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Entity Type | Organization
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Legal Business Name | ANTHONY B. LOWE, O.D., P.L.L.C.
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 10/27/2008
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Provider Practice Location Address
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Address Line | 4008 MACCORKLE AVE SW
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City | CHARLESTON
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State | WV
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Zip | 25309-1510
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Country | US
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Telephone | 304-206-8354
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Fax |
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Provider Business Mailing Address
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Address Line | 200 QUARRIER ST
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City | CHARLESTON
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State | WV
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Zip | 25301-2006
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Country | US
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Telephone | 304-206-8354
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANTHONY B. LOWE
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Credential | O.D.
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Telephone | 304-206-8354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1019-OD
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License Number State | WV
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