Provider Demographics
NPI:1679794705
Name:OWENS, LINDA PAPOULA (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:PAPOULA
Last Name:OWENS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 GRANITE AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02720
Mailing Address - Country:US
Mailing Address - Phone:617-698-0022
Mailing Address - Fax:
Practice Address - Street 1:408 GRANITE AVE
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-5608
Practice Address - Country:US
Practice Address - Phone:617-698-0022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1733111N00000X
NYX006329111N00000X
NJ4000111N00000X
DEF1-0000306111N00000X
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor