Provider Demographics
NPI:1508034604
Name:CLEMENTS, CHRISTEN BOWMAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTEN
Middle Name:BOWMAN
Last Name:CLEMENTS
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 1:7921 BROAD RIVER RD
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-2358
Mailing Address - Country:US
Mailing Address - Phone:803-509-1855
Mailing Address - Fax:
Practice Address - Street 1:7921 BROAD RIVER RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-2358
Practice Address - Country:US
Practice Address - Phone:803-749-7494
Practice Address - Fax:800-823-1232
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3778111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor