MEDICARE: J KENNETH BOWMAN DC INC PC

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

General Provider Information

NPI Number	:	1568641538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J KENNETH BOWMAN DC INC PC

Provider Business Mailing Address
First Line	:	SUITE F
Second Line	:	311 MAPLE AVE WEST
City	:	VIENNA
State	:	VA
Zip	:	22180-4309
Country	:	US
Telephone Number	:	703-281-2844
Fax Number	:	703-281-4967

Provider Business Practice Location Address
First Line	:	311 MAPLE AVE W
Second Line	:	SUITE F
City	:	VIENNA
State	:	VA
Zip	:	22180-4309
Country	:	US
Telephone Number	:	703-281-2844
Fax Number	:	703-281-4967

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHN KENNETH BOWMAN
Credential	:	DC
Telephone Number	:	703-281-2844

Provider Enumeration Date	:	10/26/2007
Last Update Date	:	06/16/2008

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