Provider Demographics
NPI:1255938981
Name:BOWKER, TAYLOR LAUREN (DC)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:LAUREN
Last Name:BOWKER
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 1:220 VINE ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-1627
Mailing Address - Country:US
Mailing Address - Phone:715-381-9965
Mailing Address - Fax:
Practice Address - Street 1:220 VINE ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-1627
Practice Address - Country:US
Practice Address - Phone:715-381-9965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6758111N00000X
WI5710-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor