Individual
JACK REYES LOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
2605 N LEBANON ST, LEBANON, IN 46052-1476
(765) 485-8124
Mailing address
2605 N LEBANON ST, LEBANON, IN 46052-1476
(765) 485-8124
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28146216A
IN
363L00000X
Nurse Practitioner
Primary
71003966
IN
Other
Enumeration date
06/11/2012
Last updated
06/29/2015
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