MEDICARE: MR. BUFORD CRAIG LOWERY PT

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
1	225100000X	Physical Therapist	04631	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295722759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BUFORD CRAIG LOWERY PT

Provider Business Mailing Address
First Line	:	7410 WESTLAKE RD
Second Line	:
City	:	STERLINGTON
State	:	LA
Zip	:	71280-3226
Country	:	US
Telephone Number	:	318-372-0463
Fax Number	:

Provider Business Practice Location Address
First Line	:	7410 WESTLAKE RD
Second Line	:
City	:	STERLINGTON
State	:	LA
Zip	:	71280-3226
Country	:	US
Telephone Number	:	318-372-0463
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	02/18/2016

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