Healthcare Provider Details

I. General information

NPI: 1831054576
Provider Name (Legal Business Name): CHRISTOPHER SHANE OWENS LPTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 FLOYD PIKE
HILLSVILLE VA
24343-1694
US

IV. Provider business mailing address

182 SUNRISE CREST LN
HILLSVILLE VA
24343-4677
US

V. Phone/Fax

Practice location:
  • Phone: 276-733-3884
  • Fax: 276-733-3884
Mailing address:
  • Phone: 276-733-3884
  • Fax: 276-733-3884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2306603908
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: