Provider Demographics
NPI:1205029055
Name:BOWERMAN, NORMAN JAY (DOCTOR OF CHIROPRACT)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:JAY
Last Name:BOWERMAN
Suffix:
Gender:M
Credentials:DOCTOR OF CHIROPRACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 NORTH 10TH STREET
Mailing Address - Street 2:
Mailing Address - City:SANTA PAULA
Mailing Address - State:CA
Mailing Address - Zip Code:93060-2803
Mailing Address - Country:US
Mailing Address - Phone:805-525-2015
Mailing Address - Fax:805-933-9866
Practice Address - Street 1:136 N 10TH ST
Practice Address - Street 2:
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-2803
Practice Address - Country:US
Practice Address - Phone:805-525-2015
Practice Address - Fax:805-933-9866
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor