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General NPI Number Information
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NPI Number | 1295382448
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Entity Type | Individual
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Provider Name | KATELYNN OWENS DPT
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Gender | Female
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 06/11/2024
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Provider Practice Location Address
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Address Line | 8892 N 32ND ST STE 2
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City | RICHLAND
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State | MI
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Zip | 49083-8555
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Country | US
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Telephone | 269-775-6021
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Fax | 866-562-4693
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Provider Business Mailing Address
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Address Line | 607 DEWEY AVE NW STE 300
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City | GRAND RAPIDS
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State | MI
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Zip | 49504-7335
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Country | US
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Telephone | 616-356-5000
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Fax | 616-356-5001
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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 | 5501019302
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License Number State | MI
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