Organization
LAFAYETTE CHIROPRACTIC LLC
Active
Parent organization
LAFAYETTE CHIROPRACTIC LLC
Other names
WAGNER CHIROPRACTIC CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAFAYETTE CHIROPRACTIC LLC
Authorized official
DAVID ALAN BOWMAN DC (OWNER)
(765) 448-1674
Entity
Organization
Contact information
Practice address
3778 UNION ST., LAFAYETTE, IN 47905-4453
(765) 448-1674
(765) 449-0847
Mailing address
3778 UNION ST., LAFAYETTE, IN 47905-4453
(765) 448-1674
(765) 449-0847
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
111NP0017X
Pediatric Chiropractor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300066310
—
IN
Enumeration date
10/11/2022
Last updated
10/25/2022
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