=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962366153
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PATRICK BOWER
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2025
-----------------------------------------------------
Last Update Date | 12/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 80 WEST AVE STE 104
-----------------------------------------------------
City | BROCKPORT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14420-1309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-331-9919
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16567 STATE ROUTE 31
-----------------------------------------------------
City | HOLLEY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14470-9016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 014024
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------