=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811040090
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET ANN LOWDERMILK PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 S DAVY CROCKETT PKWY WALTERS STATE COMMUNITY COLLEGE
-----------------------------------------------------
City | MORRISTOWN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37813-1908
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-585-6986
-----------------------------------------------------
Fax | 423-585-6791
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 181 YOUNG RD
-----------------------------------------------------
City | JOHNSON CITY
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37604-3301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-975-0580
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 0000005448
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------