Provider Demographics
NPI:1851987515
Name:CLOWSER, CAMERON (DC)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:CLOWSER
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 1:302 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-3738
Mailing Address - Country:US
Mailing Address - Phone:540-354-4090
Mailing Address - Fax:
Practice Address - Street 1:2110 CAROLINA AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-1738
Practice Address - Country:US
Practice Address - Phone:540-343-0055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104-557707111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor