Provider Demographics
NPI:1174648067
Name:BOWMAN, JOHN CARL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CARL
Last Name:BOWMAN
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 1:10781 TRUMAN ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79118-5336
Mailing Address - Country:US
Mailing Address - Phone:806-220-5851
Mailing Address - Fax:
Practice Address - Street 1:3501 S SONCY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6407
Practice Address - Country:US
Practice Address - Phone:806-351-2708
Practice Address - Fax:806-351-2349
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10382111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor