Provider Demographics
NPI:1174995328
Name:LOWE, ROSEMARY (MA41664)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:MA41664
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2206
Mailing Address - Street 2:
Mailing Address - City:ONECO
Mailing Address - State:FL
Mailing Address - Zip Code:34264
Mailing Address - Country:US
Mailing Address - Phone:941-504-2237
Mailing Address - Fax:
Practice Address - Street 1:1211 56TH AVENUE TER E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-5943
Practice Address - Country:US
Practice Address - Phone:941-504-2237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA41664225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL225700000XOtherMASSAGE THERAPIST