Provider Demographics
NPI:1093092306
Name:OWAIS, THURAIA TAYER (DC)
Entity Type:Individual
Prefix:
First Name:THURAIA
Middle Name:TAYER
Last Name:OWAIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12276 SAN JOSE BLVD STE 512
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-8618
Mailing Address - Country:US
Mailing Address - Phone:904-683-4476
Mailing Address - Fax:904-458-8994
Practice Address - Street 1:2950 HALCYON LN STE 201
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-6690
Practice Address - Country:US
Practice Address - Phone:904-683-4476
Practice Address - Fax:904-458-8994
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10413111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor