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General NPI Number Information
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NPI Number | 1932527595
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Entity Type | Organization
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Legal Business Name | OWENS PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 04/01/2014
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Last Update Date | 04/01/2014
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Provider Practice Location Address
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Address Line | 725 PROVIDENCE RD SUITE 205
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City | CHARLOTTE
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State | NC
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Zip | 28207-2370
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Country | US
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Telephone | 980-297-1785
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Fax | 704-342-3393
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Provider Business Mailing Address
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Address Line | 3907 EASTSHIRE CT
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City | CHARLOTTE
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State | NC
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Zip | 28226-3104
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Country | US
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Telephone | 980-297-1785
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Fax | 704-342-3393
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DENISE IRENE OWENS
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Credential | PT
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Telephone | 980-297-1785
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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 | 5372
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License Number State | NC
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