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Individual

MAGGIE LOWENHAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1025 E 7TH ST, BLOOMINGTON, IN 47405-7109
(574) 344-9600
Mailing address
61550 BROMPTON RD, SOUTH BEND, IN 46614-6438
(157) 423-1003

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2255A2300X
ATHLETIC TRAINING
IN
01
390200000X
ATHLETIC TRAINING STUDENT
IN
Enumeration date
10/16/2018
Last updated
10/16/2018
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