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General NPI Number Information
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NPI Number | 1104280452
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Entity Type | Organization
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Legal Business Name | R DANE OWENS CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 04/12/2016
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 27 W MAIN ST STE A
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City | SANTAQUIN
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State | UT
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Zip | 84655-5641
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Country | US
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Telephone | 801-609-7291
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Fax |
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Provider Business Mailing Address
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Address Line | 392 E 12300 S SUITE C
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City | DRAPER
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State | UT
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Zip | 84020-8181
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Country | US
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Telephone | 801-849-1029
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Fax | 801-890-0513
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Authorized Official
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Title or Position | CHIROPRATIC PHYSICIAN
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Name | ROBERT DANE OWENS
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Credential | D.C.
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Telephone | 801-698-4493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 9710732-1202
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License Number State | UT
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