Healthcare Provider Details

I. General information

NPI: 1336941376
Provider Name (Legal Business Name): TYLER M BOWERSOX DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13305 PANAMA CITY BEACH PKWY
PANAMA CITY BEACH FL
32407-2844
US

IV. Provider business mailing address

13305 PANAMA CITY BEACH PKWY
PANAMA CITY BEACH FL
32407-2844
US

V. Phone/Fax

Practice location:
  • Phone: 850-234-2242
  • Fax:
Mailing address:
  • Phone: 850-234-2242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number15537
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: