Provider Demographics
NPI:1326144775
Name:BOWMAN, LATANYA TERRAIN (DC)
Entity Type:Individual
Prefix:DR
First Name:LATANYA
Middle Name:TERRAIN
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8728 ARBOR CREEK DR STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0542
Mailing Address - Country:US
Mailing Address - Phone:704-946-2054
Mailing Address - Fax:704-727-5258
Practice Address - Street 1:8728 ARBOR CREEK DR STE A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269
Practice Address - Country:US
Practice Address - Phone:704-946-2054
Practice Address - Fax:704-727-5258
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000002116111N00000X
NC3872111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor