Healthcare Provider Details

I. General information

NPI: 1386801629
Provider Name (Legal Business Name): MOWRY CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 N LIBERTY ST STE R
POWELL OH
43065-7804
US

IV. Provider business mailing address

240 N LIBERTY ST STE R
POWELL OH
43065-7804
US

V. Phone/Fax

Practice location:
  • Phone: 614-436-9070
  • Fax: 614-436-8803
Mailing address:
  • Phone: 614-436-9070
  • Fax: 614-436-8803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC1945
License Number StateOH

VIII. Authorized Official

Name: DR. ANDREW L MOWRY
Title or Position: OWNER
Credential: DC
Phone: 614-436-9070