Provider Demographics
NPI:1679899488
Name:BOWERS, RYAN WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:WAYNE
Last Name:BOWERS
Suffix:
Gender:M
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:PO BOX 2632
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29071-2632
Mailing Address - Country:US
Mailing Address - Phone:843-817-0242
Mailing Address - Fax:
Practice Address - Street 1:103 SUM MOR DR
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4828
Practice Address - Country:US
Practice Address - Phone:803-254-4699
Practice Address - Fax:803-851-1235
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3550111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor