Provider Demographics
NPI:1659666253
Name:OWENS, GREGORY M
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:M
Last Name:OWENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11286
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-6286
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5095 NAPILIHAU ST
Practice Address - Street 2:STE 205
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-8800
Practice Address - Country:US
Practice Address - Phone:808-669-4035
Practice Address - Fax:808-669-0740
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor