Provider Demographics
NPI:1821289695
Name:JOWDY, DAVID ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROBERT
Last Name:JOWDY
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 1:2307 N ROCK RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-2819
Mailing Address - Country:US
Mailing Address - Phone:316-867-0874
Mailing Address - Fax:
Practice Address - Street 1:2307 N ROCK RD
Practice Address - Street 2:SUITE 500
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-2819
Practice Address - Country:US
Practice Address - Phone:316-867-0874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05286111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor