=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558554527
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCOTT A. OWENS, D.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/23/2007
-----------------------------------------------------
Last Update Date | 06/18/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 503 JEFFERSON ST
-----------------------------------------------------
City | EAST LIVERPOOL
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43920-2837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-385-7878
-----------------------------------------------------
Fax | 330-385-9122
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 503 JEFFERSON STREET
-----------------------------------------------------
City | EAST LIVERPOOL
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43920-2837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-385-7878
-----------------------------------------------------
Fax | 330-385-9122
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR
-----------------------------------------------------
Name | DR. SCOTT A OWENS
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 330-385-7878
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2056
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------