Provider Demographics
NPI:1336918580
Name:BOWEN, CALLIE JO (DC)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:JO
Last Name:BOWEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W MCGAUGHY ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MO
Mailing Address - Zip Code:64644-7215
Mailing Address - Country:US
Mailing Address - Phone:712-242-7476
Mailing Address - Fax:
Practice Address - Street 1:101 S DAVIS ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MO
Practice Address - Zip Code:64644-1405
Practice Address - Country:US
Practice Address - Phone:712-242-7476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-29
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023050508111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor