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General NPI Number Information
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NPI Number | 1821546045
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Entity Type | Organization
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Legal Business Name | LOW T COMPLETE CLINIC
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Dates
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Enumeration Date | 09/16/2016
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 2000 OXFORD DR SUITE 440
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City | BETHEL PARK
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State | PA
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Zip | 15102-1827
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Country | US
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Telephone | 412-833-2233
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Fax | 412-833-2293
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Provider Business Mailing Address
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Address Line | 2000 OXFORD DR SUITE 440
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City | BETHEL PARK
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State | PA
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Zip | 15102-1827
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Country | US
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Telephone | 412-833-2233
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Fax | 412-833-2293
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Authorized Official
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Title or Position | CEO
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Name | DR. JOEL WARSHAW
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Credential | M.D.
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Telephone | 412-833-2233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MD057587L
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License Number State | PA
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