MEDICARE: KEITH 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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1629814835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH LOWELL

Provider Business Mailing Address
First Line	:	2240 BAXTER RD
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99504-3281
Country	:	US
Telephone Number	:	907-348-7782
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 BAXTER RD
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99504-3281
Country	:	US
Telephone Number	:	907-348-7782
Fax Number	:

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

Provider Enumeration Date	:	07/08/2024
Last Update Date	:	07/08/2024

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Directions to “ KEITH LOWELL ” Practice Location

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