Provider Demographics
NPI:1477717288
Name:OWEN, MARY R (MS)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:R
Last Name:OWEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3850 S NATIONAL AVE
Mailing Address - Street 2:HULSTON CANCER CENTER, SUITE 120
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5287
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3850 S NATIONAL AVE
Practice Address - Street 2:HULSTON CANCER CENTER, SUITE 120
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5287
Practice Address - Country:US
Practice Address - Phone:417-269-2110
Practice Address - Fax:417-269-5280
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS