MEDICARE: OWC, INC.

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
1	261Q00000X	Clinic/Center
2	111N00000X	Chiropractor	CHIA-1515	ID

General Provider Information

NPI Number	:	1053668889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OWC, INC.

Provider Business Mailing Address
First Line	:	830 MICHIGAN AVE
Second Line	:
City	:	OROFINO
State	:	ID
Zip	:	83544-7005
Country	:	US
Telephone Number	:	208-476-7091
Fax Number	:	866-993-2828

Provider Business Practice Location Address
First Line	:	830 MICHIGAN AVE
Second Line	:
City	:	OROFINO
State	:	ID
Zip	:	83544-7005
Country	:	US
Telephone Number	:	208-476-7091
Fax Number	:	866-993-2828

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. DAMON J POPOVICS
Credential	:	DC
Telephone Number	:	208-476-7091

Provider Enumeration Date	:	08/10/2012
Last Update Date	:	03/24/2020

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Directions to “OWC, INC. ” Practice Location

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