Provider Demographics
NPI:1801865035
Name:BOWDEN, GARY G (DC)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:G
Last Name:BOWDEN
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 1:333 MAIN STREET
Mailing Address - Street 2:PO BOX C
Mailing Address - City:MC GREGOR
Mailing Address - State:IA
Mailing Address - Zip Code:52157-0503
Mailing Address - Country:US
Mailing Address - Phone:563-873-3404
Mailing Address - Fax:563-873-3405
Practice Address - Street 1:333 MAIN ST
Practice Address - Street 2:
Practice Address - City:MC GREGOR
Practice Address - State:IA
Practice Address - Zip Code:52157-8778
Practice Address - Country:US
Practice Address - Phone:563-873-3404
Practice Address - Fax:563-873-3405
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04025111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA01783OtherBLUE CROSS BLUE SHIELD
IA01783Medicare ID - Type Unspecified
IA01783OtherBLUE CROSS BLUE SHIELD