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General NPI Number Information
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NPI Number | 1669139432
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Entity Type | Individual
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Provider Name | OWEN WILLIAMS DPT
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Gender | Male
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Dates
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Enumeration Date | 11/29/2021
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 1007 GROVE RD STE A
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City | GREENVILLE
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State | SC
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Zip | 29605-4630
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Country | US
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Telephone | 864-233-5128
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Fax |
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Provider Business Mailing Address
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Address Line | 900 ROLLINGVIEW LN
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City | COLUMBIA
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State | SC
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Zip | 29210-4925
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Country | US
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Telephone | 828-638-2500
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Fax |
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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 | 11040
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License Number State | SC
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