Provider Demographics
NPI:1720218548
Name:BOWMAN, GARY ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:ALAN
Last Name:BOWMAN
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 1:4015 PLAINFIELD NAPERVILLE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-4136
Mailing Address - Country:US
Mailing Address - Phone:630-904-9700
Mailing Address - Fax:630-904-9713
Practice Address - Street 1:4015 PLAINFIELD NAPERVILLE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-4136
Practice Address - Country:US
Practice Address - Phone:630-904-9700
Practice Address - Fax:630-904-9713
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011477111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor