Provider Demographics
NPI:1851345664
Name:BOWEN, SALLY ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:SALLY
Middle Name:ANN
Last Name:BOWEN
Suffix:
Gender:F
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 223489
Mailing Address - Street 2:
Mailing Address - City:PRINCEVILLE
Mailing Address - State:HI
Mailing Address - Zip Code:96722-3489
Mailing Address - Country:US
Mailing Address - Phone:808-826-7000
Mailing Address - Fax:808-826-7600
Practice Address - Street 1:5-4280 KUHIO HWY
Practice Address - Street 2:SUITE B-206
Practice Address - City:PRINCEVILLE
Practice Address - State:HI
Practice Address - Zip Code:96722-3489
Practice Address - Country:US
Practice Address - Phone:808-826-7000
Practice Address - Fax:808-826-7600
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI55962Medicare PIN
HIT03088Medicare UPIN