Provider Demographics
NPI:1689695793
Name:BOWMAN, SANDY LYNN BABER (DC)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:LYNN BABER
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:LYNN
Other - Last Name:BABER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2600 UNIVERSITY AVE
Mailing Address - Street 2:STE 212
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1462
Mailing Address - Country:US
Mailing Address - Phone:515-223-1222
Mailing Address - Fax:515-223-1221
Practice Address - Street 1:2600 UNIVERSITY AVE
Practice Address - Street 2:STE 212
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1462
Practice Address - Country:US
Practice Address - Phone:515-223-1222
Practice Address - Fax:515-223-1221
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06942111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA58205OtherWELLMARK BLUE CROSS
IA58205OtherWELLMARK BLUE CROSS