Provider Demographics
NPI:1427258649
Name:SOWLE, LEO D (DC)
Entity type:Individual
Prefix:DR
First Name:LEO
Middle Name:D
Last Name:SOWLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22190 GARRISON ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2260
Mailing Address - Country:US
Mailing Address - Phone:313-359-9500
Mailing Address - Fax:313-565-1600
Practice Address - Street 1:22190 GARRISON ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2260
Practice Address - Country:US
Practice Address - Phone:313-359-9500
Practice Address - Fax:313-565-1600
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005598111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor