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General NPI Number Information
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NPI Number | 1669666400
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Entity Type | Organization
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Legal Business Name | FIRST WELLNESS
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Dates
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Enumeration Date | 09/05/2007
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 7739 NORTHCROSS DR SUITE J
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City | AUSTIN
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State | TX
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Zip | 78757-1700
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Country | US
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Telephone | 512-451-9655
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Fax | 512-380-9599
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Provider Business Mailing Address
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Address Line | 7739 NORTHCROSS DR SUITE J
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City | AUSTIN
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State | TX
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Zip | 78757-1700
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Country | US
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Telephone | 512-451-9655
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Fax | 512-380-9599
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. JACK HUNTER OWEN
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Credential | D.C.
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Telephone | 512-451-9655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 8629
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License Number State | TX
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