Individual
KENNETH RAY LOWTHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
965 BERRYMAN RD, UNIT A, POCATELLO, ID 83201-5572
(208) 221-6121
(888) 798-7346
Mailing address
965 BERRYMAN RD, UNIT A, POCATELLO, ID 83201-5572
(208) 221-6121
(888) 798-7346
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1104A
ID
Other
Enumeration date
09/15/2011
Last updated
08/09/2013
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