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General NPI Number Information
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NPI Number | 1861192411
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Entity Type | Individual
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Provider Name | MR. CHRISTOPHER LEE OWENS
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Gender | Male
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Dates
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Enumeration Date | 03/02/2023
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 464 INVESTORS PL STE 102C
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-1167
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Country | US
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Telephone | 757-945-2536
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 JADENS WAY
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City | CHESAPEAKE
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State | VA
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Zip | 23320-2470
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Country | US
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Telephone | 757-769-9237
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 457803011
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License Number State | VA
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