Provider Demographics
NPI:1700931326
Name:BOWLIN, RYAN N (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:N
Last Name:BOWLIN
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 1:1463 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:NE
Mailing Address - Zip Code:69357-1455
Mailing Address - Country:US
Mailing Address - Phone:308-623-1313
Mailing Address - Fax:308-623-1315
Practice Address - Street 1:1463 19TH AVE
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:NE
Practice Address - Zip Code:69357-1455
Practice Address - Country:US
Practice Address - Phone:308-623-1313
Practice Address - Fax:308-623-1315
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1450111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor