Provider Demographics
NPI:1275638074
Name:BOWERS, BEN (DC, DABCI)
Entity Type:Individual
Prefix:MR
First Name:BEN
Middle Name:
Last Name:BOWERS
Suffix:
Gender:M
Credentials:DC, DABCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 N ROCK RD
Mailing Address - Street 2:SUITE 503
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1327
Mailing Address - Country:US
Mailing Address - Phone:316-636-5333
Mailing Address - Fax:316-636-5338
Practice Address - Street 1:3450 N ROCK RD
Practice Address - Street 2:SUITE 503
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-1327
Practice Address - Country:US
Practice Address - Phone:316-636-5333
Practice Address - Fax:316-636-5338
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-3858111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS060828OtherBLUE CROSS BLUE SHIELD
KSU06410Medicare UPIN