Provider Demographics
NPI:1063639359
Name:BOWDEN, COREY DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:DEAN
Last Name:BOWDEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:958 NORTH 3500 WEST
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041
Mailing Address - Country:US
Mailing Address - Phone:801-444-1230
Mailing Address - Fax:801-444-1228
Practice Address - Street 1:1649 W ANTELOPE DR
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1184
Practice Address - Country:US
Practice Address - Phone:801-444-1230
Practice Address - Fax:801-444-1228
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6304094-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor