Provider Demographics
NPI:1487707295
Name:BOWERS CHIROPRACTIC CENTER, P.C.
Entity type:Organization
Organization Name:BOWERS CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-464-6489
Mailing Address - Street 1:37342 WEYMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-4096
Mailing Address - Country:US
Mailing Address - Phone:734-464-6489
Mailing Address - Fax:
Practice Address - Street 1:216 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1918
Practice Address - Country:US
Practice Address - Phone:248-685-2623
Practice Address - Fax:248-684-9013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002799111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F35081Medicare ID - Type UnspecifiedMEDICARE
MI950F35081Medicare UPIN