Provider Demographics
NPI:1689865388
Name:BOWMAN, DEVIN DEAN (DC)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:DEAN
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 1:1727 W JESSE JAMES RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:EXCELSIOR SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64024-1801
Mailing Address - Country:US
Mailing Address - Phone:816-630-2225
Mailing Address - Fax:816-637-2225
Practice Address - Street 1:1727 W JESSE JAMES RD
Practice Address - Street 2:SUITE 5
Practice Address - City:EXCELSIOR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64024-1801
Practice Address - Country:US
Practice Address - Phone:816-630-2225
Practice Address - Fax:816-637-2225
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004003311111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOS49C986Medicare PIN
U99558Medicare UPIN