Provider Demographics
NPI:1326205675
Name:OWENS, DENISE IRENE (PT)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:IRENE
Last Name:OWENS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:IRENE
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7142 WINDYRUSH RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3106
Mailing Address - Country:US
Mailing Address - Phone:704-544-6505
Mailing Address - Fax:
Practice Address - Street 1:125 BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3227
Practice Address - Country:US
Practice Address - Phone:704-316-1918
Practice Address - Fax:704-316-1924
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5372225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist