Individual
MR. BEAU BERNELL LOWERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, ATC
Contact information
Practice address
8080 BLUEBONNET BLVD, SUIT #110, BATON ROUGE, LA 70810-7827
(225) 408-7990
(225) 408-7989
Mailing address
8080 BLUEBONNET BLVD, SUIT #110, BATON ROUGE, LA 70810-7827
(225) 408-7990
(225) 408-7989
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
05277R
LA
2255A2300X
Athletic Trainer
ATH.J00349
LA
Other
Enumeration date
08/20/2009
Last updated
08/25/2009
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