Provider Demographics
NPI:1093817660
Name:GOWER, ALICIA (DC)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:GOWER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936B S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PENNSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08070-9641
Mailing Address - Country:US
Mailing Address - Phone:856-759-4644
Mailing Address - Fax:856-759-4722
Practice Address - Street 1:936B S BROADWAY
Practice Address - Street 2:
Practice Address - City:PENNSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08070-9641
Practice Address - Country:US
Practice Address - Phone:856-759-4644
Practice Address - Fax:856-759-4722
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000637111N00000X
NJ38MC00646500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor