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GREGORY KEITH LOWE

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1598761991

Individual Registrant:
 GREGORY KEITH LOWE 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
911 N 3RD AVE  CHATSWORTH, GA 30705-2115 US
Tel: 706-695-4676  Fax: 706-695-7364

Contact information for business:
1950 OLD GALLOWS RD STE 520  VIENNA, VA 22182-3970 US
Tel: 703-847-8899  Fax: 866-795-4020

Registration Information:
NPI: 1598761991
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
GAOPT001580

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
00787971AGA05
TAX ID582350453GA01




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