Individual
GREGORY KEITH LOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
911 N 3RD AVE, CHATSWORTH, GA 30705-2115
(706) 695-4676
(706) 695-7364
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(866) 795-4020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001580
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00787971A
—
GA
01
—
582350453
TAX ID
GA
Enumeration date
06/22/2005
Last updated
02/16/2018
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