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General NPI Number Information
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NPI Number | 1477663623
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Entity Type | Organization
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Legal Business Name | GOWEN CHIROPRACTIC AND REHABILITATION, INC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2909 W 12TH AVE
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City | EMPORIA
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State | KS
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Zip | 66801-6272
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Country | US
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Telephone | 620-342-5663
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Fax | 620-342-5663
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Provider Business Mailing Address
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Address Line | 2909 W 12TH AVE
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City | EMPORIA
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State | KS
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Zip | 66801-6272
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Country | US
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Telephone | 620-342-5663
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Fax | 620-342-5663
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | MS. DANA MICHELLE GOWEN
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Credential | DC
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Telephone | 620-342-5663
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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 | 01-04614
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License Number State | KS
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