Provider Demographics
NPI:1598245631
Name:OWENS, SYLVIA (DC)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:BRIDGES
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2132 SHADYGROVE WALK
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168-6333
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7202 TARA BLVD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1902
Practice Address - Country:US
Practice Address - Phone:770-472-8989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor