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NPI Code Detail

MEDICARE: ROGER WYATT OWENS D.C.

MEDICARE: ROGER WYATT OWENS D.C.
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
1111N00000XChiropractor005470MO

General Provider Information

NPI Number : 1932108941
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROGER WYATT OWENS D.C.
Provider Business Mailing Address
First Line : 2716 CEDARWOOD CT
Second Line :
City : JEFFERSON CITY
State : MO
Zip : 65109-9309
Country : US
Telephone Number : 573-634-7194
Fax Number :
Provider Business Practice Location Address
First Line : 3349 AMERICAN AVE
Second Line : SUITE B
City : JEFFERSON CITY
State : MO
Zip : 65109-1079
Country : US
Telephone Number : 573-635-9655
Fax Number : 573-635-6741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 08/02/2011

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Directions to “ ROGER WYATT OWENS D.C.” Practice Location

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