Healthcare Provider Details

I. General information

NPI: 1891979472
Provider Name (Legal Business Name): OWENS CHIROPRACTIC AND REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7319 MONTGOMERY ROAD
CINCINNATI OH
45236
US

IV. Provider business mailing address

P.O. BOX 36146
CINCINNATI OH
45236
US

V. Phone/Fax

Practice location:
  • Phone: 513-784-0084
  • Fax: 513-784-0086
Mailing address:
  • Phone: 513-784-0084
  • Fax: 513-784-0086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number3324
License Number StateOH

VIII. Authorized Official

Name: DR. STEPHANIE OWENS
Title or Position: MANAGING MEMBER
Credential: D.C.
Phone: 513-784-0084