Provider Demographics
NPI:1528466323
Name:FOWLER, JOSEPH JR
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:FOWLER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11770 HAYNES BRIDGE RD STE 205-215
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-1966
Mailing Address - Country:US
Mailing Address - Phone:770-527-3525
Mailing Address - Fax:
Practice Address - Street 1:11770 HAYNES BRIDGE RD STE 205-215
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-1966
Practice Address - Country:US
Practice Address - Phone:888-430-5999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009435111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor