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NPI Code Detail

MEDICARE: NOAH CHANNING OWENS PT, DPT

MEDICARE: NOAH CHANNING OWENS PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1405670TX
2225100000XPhysical TherapistCP042531TSC

General Provider Information

NPI Number : 1033915061
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOAH CHANNING OWENS PT, DPT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-238-7217
Fax Number :
Provider Business Practice Location Address
First Line : 9512 DORCHESTER RD STE 140
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29485-4305
Country : US
Telephone Number : 843-695-7970
Fax Number : 843-695-7971
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2025
Last Update Date : 02/20/2025

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