Provider Demographics
NPI:1609977024
Name:KENNETH F. SMITHBOWER D.C.
Entity Type:Organization
Organization Name:KENNETH F. SMITHBOWER D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:F
Authorized Official - Last Name:SMITHBOWER
Authorized Official - Suffix:
Authorized Official - Credentials:D,C,
Authorized Official - Phone:814-472-8481
Mailing Address - Street 1:115 N JULIAN ST
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-1516
Mailing Address - Country:US
Mailing Address - Phone:814-472-8481
Mailing Address - Fax:
Practice Address - Street 1:115 N JULIAN ST
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-1516
Practice Address - Country:US
Practice Address - Phone:814-472-8481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1536660OtherHIGHMARK