Provider Demographics
NPI:1285810606
Name:BOWERS, JASON GLENN (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:GLENN
Last Name:BOWERS
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 1:415 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-3370
Mailing Address - Country:US
Mailing Address - Phone:732-998-1842
Mailing Address - Fax:
Practice Address - Street 1:415 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BEACH
Practice Address - State:NJ
Practice Address - Zip Code:08742-3370
Practice Address - Country:US
Practice Address - Phone:732-998-1842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00473900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor