Provider Demographics
NPI:1386801629
Name:MOWRY CHIROPRACTIC INC
Entity type:Organization
Organization Name:MOWRY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOWRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-436-9070
Mailing Address - Street 1:240 N LIBERTY ST STE R
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7804
Mailing Address - Country:US
Mailing Address - Phone:614-436-9070
Mailing Address - Fax:614-436-8803
Practice Address - Street 1:240 N LIBERTY ST STE R
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7804
Practice Address - Country:US
Practice Address - Phone:614-436-9070
Practice Address - Fax:614-436-8803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC1945111N00000X
OH3359111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9354111OtherMEDICARE PTAN
OH4159601Medicare PIN