Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 851729951202 | UT |
NPI | 1275627754 |
---|---|
Provider Name | Dr. Joseph Vernal Bowden |
First Address | Layton, UT 84040-4004 |
Second Address | Layton, UT 84040-4004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 20/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
870395551005 | (05) | UT |