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General NPI Number Information
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NPI Number | 1891908836
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Entity Type | Individual
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Provider Name | TOMIKA LASHA LOWE-LOPEZ PT, DPT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 09/22/2023
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Provider Practice Location Address
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Address Line | 619 S MARION AVE
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City | LAKE CITY
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State | FL
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Zip | 32025-5808
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Country | US
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Telephone | 706-987-3601
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Fax |
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Provider Business Mailing Address
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Address Line | 619 S MARION AVE
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City | LAKE CITY
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State | FL
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Zip | 32025-5808
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Country | US
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Telephone | 706-987-3601
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT012272
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT31282
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT003899
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT17532
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License Number State | FL
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