Provider Demographics
NPI:1528163409
Name:BLOWERS, BYRON J (DC)
Entity type:Individual
Prefix:
First Name:BYRON
Middle Name:J
Last Name:BLOWERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:BYRON
Other - Middle Name:J
Other - Last Name:BLOWERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC, LAC
Mailing Address - Street 1:3712 LOCKPORT ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1225
Mailing Address - Country:US
Mailing Address - Phone:701-223-8873
Mailing Address - Fax:701-223-1014
Practice Address - Street 1:3712 LOCKPORT ST
Practice Address - Street 2:SUITE B
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-5535
Practice Address - Country:US
Practice Address - Phone:701-223-8873
Practice Address - Fax:701-223-1014
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND505111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDU10362Medicare UPIN