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General NPI Number Information
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NPI Number | 1023285806
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Entity Type | Organization
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Legal Business Name | MCGOWEN FAMILY CARE CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 02/24/2012
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Provider Practice Location Address
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Address Line | 1800 HOSPITAL DR
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City | RATON
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State | NM
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Zip | 87740-2031
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Country | US
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Telephone | 575-445-0222
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Fax | 575-445-0322
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Provider Business Mailing Address
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Address Line | 1800 HOSPITAL DR
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City | RATON
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State | NM
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Zip | 87740-2031
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Country | US
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Telephone | 575-445-0222
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Fax | 575-445-0322
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | MONTY MILTON MCGOWEN
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Credential | D.C.
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Telephone | 575-445-0222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1439
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License Number State | NM
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