Provider Demographics
NPI:1265760664
Name:BOWMAN, DAVIS (DC)
Entity type:Individual
Prefix:MR
First Name:DAVIS
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 BRADLEY CT
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-3371
Mailing Address - Country:US
Mailing Address - Phone:619-749-8802
Mailing Address - Fax:888-600-5305
Practice Address - Street 1:1136 BRADLEY CT
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-3371
Practice Address - Country:US
Practice Address - Phone:619-749-8802
Practice Address - Fax:888-600-5305
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19390111N00000X
TX9731111N00000X
NJ38MC00652000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor