Healthcare Provider Details

I. General information

NPI: 1932960820
Provider Name (Legal Business Name): OWL NOW INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2024
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 E NEPESSING ST
LAPEER MI
48446-2316
US

IV. Provider business mailing address

204 E NEPESSING ST
LAPEER MI
48446-2316
US

V. Phone/Fax

Practice location:
  • Phone: 810-356-4646
  • Fax:
Mailing address:
  • Phone: 810-356-4646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: TONYA MARIE DE GROOT
Title or Position: FACILITATOR
Credential:
Phone: 810-356-4646