Provider Demographics
NPI:1326056656
Name:MICHAEL T. OWSLEY, PLLC
Entity Type:Organization
Organization Name:MICHAEL T. OWSLEY, PLLC
Other - Org Name:OWSLEY FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:OWSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-982-9440
Mailing Address - Street 1:596 WESTPORT RD STE B102
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2982
Mailing Address - Country:US
Mailing Address - Phone:270-982-9440
Mailing Address - Fax:270-982-9448
Practice Address - Street 1:596 WESTPORT RD STE B102
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2982
Practice Address - Country:US
Practice Address - Phone:270-982-9440
Practice Address - Fax:270-982-9448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4971111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00128Medicare PIN