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General NPI Number Information
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NPI Number | 1144341025
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Entity Type | Organization
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Legal Business Name | BOWEN CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/29/2008
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Provider Practice Location Address
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Address Line | 3392 STATE HIGHWAY 259 NORTH
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City | LONGVIEW
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State | TX
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Zip | 75605
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Country | US
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Telephone | 903-663-5885
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Fax | 903-663-0908
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Provider Business Mailing Address
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Address Line | PO BOX 9066
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City | LONGVIEW
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State | TX
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Zip | 75608-9066
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Country | US
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Telephone | 903-663-5885
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Fax | 903-663-0908
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARTHA RUTH BOWEN
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Credential | D.C.
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Telephone | 903-663-5885
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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 | 6817
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6818
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License Number State | TX
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