Provider Demographics
NPI:1467489989
Name:NOWEK, LUBA DAWNE (DC)
Entity Type:Individual
Prefix:DR
First Name:LUBA
Middle Name:DAWNE
Last Name:NOWEK
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 1:1540 MALLARD POND DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48855-6400
Mailing Address - Country:US
Mailing Address - Phone:517-304-5822
Mailing Address - Fax:
Practice Address - Street 1:120 N STATE ST
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-2203
Practice Address - Country:US
Practice Address - Phone:517-546-4680
Practice Address - Fax:517-546-4699
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008875111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11311864OtherCAQH
MI2301008875OtherSTATE LIC #
MI11311864OtherCAQH