MEDICARE: DR. ZACHARY BENNETT GOWER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH60760853	WA

General Provider Information

NPI Number	:	1144741265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZACHARY BENNETT GOWER DC

Provider Business Mailing Address
First Line	:	PO BOX 234
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-0234
Country	:	US
Telephone Number	:	516-965-2827
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 W PARK AVE STE 207
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3302
Country	:	US
Telephone Number	:	516-945-9636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2017
Last Update Date	:	05/26/2022

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