MEDICARE: DR HOLLI GOWER LLC

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	175F00000X	Naturopath	1331	OR

General Provider Information

NPI Number	:	1821343039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR HOLLI GOWER LLC

Provider Business Mailing Address
First Line	:	525 GLEN CREEK RD NW
Second Line	:	SUITE 230
City	:	SALEM
State	:	OR
Zip	:	97304-3161
Country	:	US
Telephone Number	:	503-339-7376
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 GLEN CREEK RD NW
Second Line	:	SUITE 230
City	:	SALEM
State	:	OR
Zip	:	97304-3161
Country	:	US
Telephone Number	:	503-339-7376
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HOLLI GOWER
Credential	:	ND
Telephone Number	:	503-339-7376

Provider Enumeration Date	:	07/13/2012
Last Update Date	:	10/09/2012

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