Organization
BOWMAN CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC MEMMOTT BOWMAN D.C. (MANAGING MEMBER)
(208) 547-4151
Entity
Organization
Contact information
Practice address
300 W 2ND S, SODA SPRINGS, ID 83276-1515
(208) 547-4151
(208) 547-4093
Mailing address
300 W 2ND S, SODA SPRINGS, ID 83276-1515
(208) 547-4151
(208) 547-4093
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
C458
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C458
CHIROPRACTIC LICENSE
ID
Enumeration date
06/10/2014
Last updated
06/10/2014
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