MEDICARE: DR. LAILA D OWENS D.C.

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	111N00000X	Chiropractor	0104556558	VA
2	111N00000X	Chiropractor	10480	FL

General Provider Information

NPI Number	:	1215121892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAILA D OWENS D.C.

Provider Business Mailing Address
First Line	:	PO BOX 246326
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-0122
Country	:	US
Telephone Number	:	305-330-2508
Fax Number	:	786-565-9499

Provider Business Practice Location Address
First Line	:	9710 STIRLING RD.
Second Line	:	SUITE 112
City	:	COOPER CITY
State	:	FL
Zip	:	33024-8018
Country	:	US
Telephone Number	:	305-330-2508
Fax Number	:	786-565-9499

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2007
Last Update Date	:	11/04/2022

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