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NPI Code Detail

MEDICARE: JONATHAN LOWELL

MEDICARE: JONATHAN LOWELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPTH12571AL
2225100000XPhysical TherapistCP052162TNC
3225100000XPhysical TherapistPT7399ME

General Provider Information

NPI Number : 1235096645
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN LOWELL
Provider Business Mailing Address
First Line : 1991 FORDHAM DR STE 102
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3774
Country : US
Telephone Number : 910-484-4653
Fax Number : 910-483-9256
Provider Business Practice Location Address
First Line : 1991 FORDHAM DR STE 102
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3774
Country : US
Telephone Number : 910-484-4653
Fax Number : 910-483-9256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2026
Last Update Date : 03/27/2026

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1578505848 — ALICE JEAN MULLHOLAND OTR/L, CHT
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1730294745 — MICHAEL S. KIM OTR/L
Practice Location Address:
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FAYETTEVILLE, NC
28304-3774
Practice Phone: 910-484-4653
Practice Fax: 910-483-9256

Directions to “ JONATHAN LOWELL ” Practice Location

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