Individual
BRYAN RICHARD LOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10583 W LAKE HAZEL RD, BOISE, ID 83709-6326
(208) 302-5950
(208) 302-5955
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2238
ID
363AM0700X
Medical Physician Assistant
PA-2238
ID
Other
Enumeration date
06/11/2022
Last updated
02/20/2024
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