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General NPI Number Information
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NPI Number | 1568237436
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Entity Type | Individual
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Provider Name | ROBERT OWSLEY LMT
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Gender | Male
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 2377 FOURTH STREET
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City | SYRACUSE
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State | OH
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Zip | 45779-0134
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Country | US
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Telephone | 740-247-5463
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Fax | 740-212-8445
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Provider Business Mailing Address
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Address Line | PO BOX 134
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City | SYRACUSE
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State | OH
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Zip | 45779-0134
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Country | US
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Telephone | 740-847-5463
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Fax | 740-212-8445
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 33.025178
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License Number State | OH
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