Provider Demographics
NPI:1750390308
Name:BOWERS FAMILY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:BOWERS FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:608-442-9909
Mailing Address - Street 1:509 COTTAGE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53716-1111
Mailing Address - Country:US
Mailing Address - Phone:608-442-9909
Mailing Address - Fax:608-442-9910
Practice Address - Street 1:509 COTTAGE GROVE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53716-1111
Practice Address - Country:US
Practice Address - Phone:608-442-9909
Practice Address - Fax:608-442-9910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4219111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty