Provider Demographics
NPI:1164884037
Name:OWENS, ROBERT DANE (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DANE
Last Name:OWENS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 W MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:SANTAQUIN
Mailing Address - State:UT
Mailing Address - Zip Code:84655-5641
Mailing Address - Country:US
Mailing Address - Phone:801-609-7291
Mailing Address - Fax:385-895-1056
Practice Address - Street 1:27 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:SANTAQUIN
Practice Address - State:UT
Practice Address - Zip Code:84655-5641
Practice Address - Country:US
Practice Address - Phone:801-609-7291
Practice Address - Fax:385-895-1056
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9710732-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor