Healthcare Provider Details

I. General information

NPI: 1932274339
Provider Name (Legal Business Name): PAMELA J OWENS DCPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6934 BEACH DR SW SUITE 2
OCEAN ISLE BEACH NC
28469-5797
US

IV. Provider business mailing address

6934 BEACH DR SW SUITE 2
OCEAN ISLE BEACH NC
28469-5797
US

V. Phone/Fax

Practice location:
  • Phone: 910-575-2225
  • Fax: 910-575-2275
Mailing address:
  • Phone: 910-575-2225
  • Fax: 910-575-2275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number3024
License Number StateNC

VIII. Authorized Official

Name: DR. PAMELA J OWENS
Title or Position: OWNER CHIROPRACTOR
Credential: DC
Phone: 910-575-2225