MEDICARE: DR. JACQUES L ROWE D.C.

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	1467	OK

General Provider Information

NPI Number	:	1184666141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUES L ROWE D.C.

Provider Business Mailing Address
First Line	:	13838 QUAIL POINTE DR
Second Line	:	STE A
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-1001
Country	:	US
Telephone Number	:	405-478-8220
Fax Number	:	405-748-4209

Provider Business Practice Location Address
First Line	:	13838 QUAIL POINTE DR
Second Line	:	STE A
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-1001
Country	:	US
Telephone Number	:	405-478-8220
Fax Number	:	405-748-4209

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	04/12/2008

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