Basic Information
Provider Information
NPI: 1043720360
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOWE
FirstName: ERIKA
MiddleName: ANGELIQUE
NamePrefix:  
NameSuffix:  
Credential: PTA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6397 LEE HWY STE 300
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374212564
CountryCode: US
TelephoneNumber: 4232387217
FaxNumber: 4233628684
Practice Location
Address1: 2050 SCENIC HWY N STE A
Address2:  
City: SNELLVILLE
State: GA
PostalCode: 300782688
CountryCode: US
TelephoneNumber: 6783447197
FaxNumber: 6783447199
Other Information
ProviderEnumerationDate: 10/02/2017
LastUpdateDate: 10/02/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225200000XPTA003847GAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant 

No ID Information.


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