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NPI 1033915061

NPI 1033915061 : NOAH CHANNING OWENS PT, DPT : SUMMERVILLE, SC

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General NPI Number Information
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    NPI Number           |    1033915061
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    Entity Type          |    Individual 
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    Provider Name        |    NOAH CHANNING OWENS PT, DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/20/2025
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    Last Update Date     |    02/20/2025
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Provider Practice Location Address
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    Address Line         |    9512 DORCHESTER RD STE 140 
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    City                 |    SUMMERVILLE
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    State                |    SC
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    Zip                  |    29485-4305
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    Country              |    US
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    Telephone            |    843-695-7970
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    Fax                  |    843-695-7971
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Provider Business Mailing Address
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    Address Line         |    1200 CORPORATE DR STE 400 
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    City                 |    HOOVER
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    State                |    AL
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    Zip                  |    35242-5424
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    Country              |    US
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    Telephone            |    423-238-7217
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    1405670
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    CP042531T
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    License Number State |    SC
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