Provider Demographics
NPI:1124408414
Name:ROWLAND CHIROPRACTIC CLINIC, PC
Entity Type:Organization
Organization Name:ROWLAND CHIROPRACTIC CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:432-617-4564
Mailing Address - Street 1:3952 E 42ND ST
Mailing Address - Street 2:STE J
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-5932
Mailing Address - Country:US
Mailing Address - Phone:432-617-4564
Mailing Address - Fax:462-617-4565
Practice Address - Street 1:3952 E 42ND ST
Practice Address - Street 2:STE J
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5932
Practice Address - Country:US
Practice Address - Phone:432-617-4564
Practice Address - Fax:462-617-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8532261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB155029OtherPTAN