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1295382448 NPI number — KATELYNN OWENS DPT

NPI Number: 1295382448
Health Care Provider/Practitioner: KATELYNN OWENS DPT

Information about “1295382448” NPI (KATELYNN OWENS DPT) exists in 1295382448 in HTML format HTML  |  1295382448 in plain Text format TXT  |  1295382448 in PDF (Portable Document Format) PDF  |  1295382448 in an XML format XML  formats.

NPI Number : 1295382448 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295382448",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OWENS",
    "FirstName": "KATELYNN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "607 DEWEY AVE NW STE 300",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GRAND RAPIDS",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "49504-7335",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "616-356-5000",
    "MailingAddressFaxNumber": "616-356-5001",
    "FirstLinePracticeLocationAddress": "8892 N 32ND ST STE 2",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RICHLAND",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "49083-8555",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "269-775-6021",
    "PracticeLocationAddressFaxNumber": "866-562-4693",
    "EnumerationDate": "08/22/2019",
    "LastUpdateDate": "06/11/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "5501019302",
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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