Healthcare Provider Details

I. General information

NPI: 1700064136
Provider Name (Legal Business Name): ROBERT EARL BOWEN D.C.,
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 10/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 BARNWELL AVE NW
AIKEN SC
29801-3903
US

IV. Provider business mailing address

237 BARNWELL AVE NW
AIKEN SC
29801-3903
US

V. Phone/Fax

Practice location:
  • Phone: 803-642-5707
  • Fax:
Mailing address:
  • Phone: 803-642-5707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1011
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number630
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: