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Individual

DR. DARYL V COWAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1 PLAZA DR, SUITE 20, PENDLETON, IN 46064-8823
(765) 778-7399
(765) 778-7399
Mailing address
1 PLAZA DR, SUITE 20, PENDLETON, IN 46064-8823
(765) 778-7399
(765) 778-7399

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001542
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000214574
BLUE NUMBER BCBS
IN
05
200167160A21
IN
01
351925531
FEDERAL TAX ID#
IN
Enumeration date
05/07/2007
Last updated
03/16/2016
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