Provider Demographics
NPI:1336202142
Name:ROWELL, ROBERT MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARK
Last Name:ROWELL
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 1:741 BRADY ST
Mailing Address - Street 2:PALMER RESEARCH CLINIC
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-5209
Mailing Address - Country:US
Mailing Address - Phone:563-884-5250
Mailing Address - Fax:563-884-5238
Practice Address - Street 1:741 BRADY ST
Practice Address - Street 2:PALMER RESEARCH CLINIC
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-5209
Practice Address - Country:US
Practice Address - Phone:563-884-5250
Practice Address - Fax:563-884-5238
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAAO5979111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAU46001Medicare UPIN