Provider Demographics
NPI:1043324197
Name:DR L E BOWERS P C
Entity Type:Organization
Organization Name:DR L E BOWERS P C
Other - Org Name:DR L E BOWERS CHIROPRACTOR P C
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-425-5454
Mailing Address - Street 1:13982 MERRIMAN RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-4259
Mailing Address - Country:US
Mailing Address - Phone:734-425-5454
Mailing Address - Fax:734-425-8779
Practice Address - Street 1:13982 MERRIMAN RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-4259
Practice Address - Country:US
Practice Address - Phone:734-425-5454
Practice Address - Fax:734-425-8779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILB002142111N00000X
MIDB004839111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H22816OtherBCBSM GROUP NUMBER