Provider Demographics
NPI:1992161830
Name:BOWLIN, LEVI TAYLOR (DC)
Entity type:Individual
Prefix:DR
First Name:LEVI
Middle Name:TAYLOR
Last Name:BOWLIN
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 1:1930 E 20TH PL STE 200E
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-2874
Mailing Address - Country:US
Mailing Address - Phone:308-641-6804
Mailing Address - Fax:
Practice Address - Street 1:1930 E 20TH PL STE 200E
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-2874
Practice Address - Country:US
Practice Address - Phone:308-641-6804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor