Provider Demographics
NPI:1437650926
Name:OWENS, TERI JOYCE
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:JOYCE
Last Name:OWENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-2035
Mailing Address - Country:US
Mailing Address - Phone:276-685-4852
Mailing Address - Fax:
Practice Address - Street 1:815 HENRY ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-2035
Practice Address - Country:US
Practice Address - Phone:276-685-4852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle