Provider Demographics
NPI:1912998626
Name:NOWLIN, BRYAN THOMAS (DC)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:THOMAS
Last Name:NOWLIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 S LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:LAMONI
Mailing Address - State:IA
Mailing Address - Zip Code:50140-1616
Mailing Address - Country:US
Mailing Address - Phone:641-784-6677
Mailing Address - Fax:641-784-7593
Practice Address - Street 1:303 S LINDEN ST
Practice Address - Street 2:
Practice Address - City:LAMONI
Practice Address - State:IA
Practice Address - Zip Code:50140-1616
Practice Address - Country:US
Practice Address - Phone:641-784-6677
Practice Address - Fax:641-784-7593
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0134841Medicaid
IA52824Medicare ID - Type Unspecified
IA0134841Medicaid