Provider Demographics
NPI:1144741265
Name:GOWER, ZACHARY BENNETT (DC)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:BENNETT
Last Name:GOWER
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:PO BOX 234
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-0234
Mailing Address - Country:US
Mailing Address - Phone:516-965-2827
Mailing Address - Fax:
Practice Address - Street 1:100 W PARK AVE STE 207
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-3302
Practice Address - Country:US
Practice Address - Phone:516-945-9636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-28
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60760853111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor