Provider Demographics
NPI:1104094051
Name:FOWLER CHIROPRACTIC OFFICE P.C.
Entity type:Organization
Organization Name:FOWLER CHIROPRACTIC OFFICE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:A
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-474-5400
Mailing Address - Street 1:549 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-4211
Mailing Address - Country:US
Mailing Address - Phone:603-474-5400
Mailing Address - Fax:603-474-2525
Practice Address - Street 1:549 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:NH
Practice Address - Zip Code:03874-4211
Practice Address - Country:US
Practice Address - Phone:603-474-5400
Practice Address - Fax:603-474-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH265-0687B111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE4410Medicare PIN