MEDICARE: LORI JUNE OWEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347E00000X	Transportation Broker	RN524017	OH
2	376J00000X	Homemaker
3	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1760229447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI JUNE OWEN

Provider Business Mailing Address
First Line	:	730 TERRACE AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44708-3710
Country	:	US
Telephone Number	:	330-303-5877
Fax Number	:

Provider Business Practice Location Address
First Line	:	730 TERRACE AVE NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44708-3710
Country	:	US
Telephone Number	:	330-303-5877
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2024
Last Update Date	:	12/02/2025

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Directions to “ LORI JUNE OWEN ” Practice Location

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