Provider Demographics
NPI:1851562953
Name:BOWE, CHRISTOPHER LAMONT (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LAMONT
Last Name:BOWE
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 1:3645 MARKETPLACE BLVD # 130-645
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-5747
Mailing Address - Country:US
Mailing Address - Phone:919-697-6976
Mailing Address - Fax:
Practice Address - Street 1:1001 VIRGINIA AVE STE 302
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30354-1367
Practice Address - Country:US
Practice Address - Phone:470-481-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00627100111N00000X
NY010972111N00000X
GACHIR008499111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ096731Medicare PIN
NJV07686Medicare UPIN