=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174561716
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOCKWOOD CHIROPRACTIC HEALTH CENTER PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2006
-----------------------------------------------------
Last Update Date | 05/21/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2850 OLD HARDIN RD
-----------------------------------------------------
City | BILLINGS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-252-3156
-----------------------------------------------------
Fax | 406-252-3156
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 31581
-----------------------------------------------------
City | BILLINGS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59107-1581
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-252-3156
-----------------------------------------------------
Fax | 406-252-3156
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. SCOT J BOWEN
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 406-252-3156
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 631
-----------------------------------------------------
License Number State | WY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 1046
-----------------------------------------------------
License Number State | MT
-----------------------------------------------------