Provider Demographics
NPI:1306310727
Name:BOWEN, CASEY (ND)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:
Last Name:BOWEN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 WEANT BLVD
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-2042
Mailing Address - Country:US
Mailing Address - Phone:303-588-1692
Mailing Address - Fax:
Practice Address - Street 1:214 8TH ST STE 209
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-3312
Practice Address - Country:US
Practice Address - Phone:303-588-1692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000163175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath