Individual
DR. WYLIE D. LOWERY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14605 POTOMAC BRANCH DR STE 300, WOODBRIDGE, VA 22191-3337
(703) 490-1112
(703) 878-8735
Mailing address
14605 POTOMAC BRANCH DR STE 300, WOODBRIDGE, VA 22191-3337
(703) 490-1112
(703) 878-8735
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
0101049758
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6400973
—
VA
Enumeration date
02/14/2006
Last updated
09/20/2022
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