Provider Demographics
NPI:1902952575
Name:BOVEE, MICHAEL L (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:BOVEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BRADY ST
Mailing Address - Street 2:SUITE 315 G
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-5214
Mailing Address - Country:US
Mailing Address - Phone:563-884-5234
Mailing Address - Fax:
Practice Address - Street 1:1000 BRADY ST
Practice Address - Street 2:SUITE 315 G
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-5214
Practice Address - Country:US
Practice Address - Phone:563-884-5234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04372111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor