Individual
DEREK R BOWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1650 S 41ST ST, MANITOWOC, WI 54220-7316
(920) 320-4700
(920) 684-2094
Mailing address
PO BOX 2290, MANITOWOC, WI 54221-2290
(920) 320-2591
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2710
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38858900
—
WI
01
—
39572209
WPS
WI
Enumeration date
10/03/2006
Last updated
10/28/2011
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