Provider Demographics
NPI:1598761017
Name:OWENS, SCOTT A (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:A
Last Name:OWENS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-2837
Mailing Address - Country:US
Mailing Address - Phone:330-385-7878
Mailing Address - Fax:330-385-9122
Practice Address - Street 1:503 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-2837
Practice Address - Country:US
Practice Address - Phone:330-385-7878
Practice Address - Fax:330-385-9122
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2056111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH145021OtherBC/BS
OH0958389Medicaid
OH0755551Medicare PIN