Provider Demographics
NPI:1710923206
Name:OWEN PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:OWEN PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:SYLVIA
Authorized Official - Last Name:LOUNDES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:517-321-1530
Mailing Address - Street 1:2201 NORTHWEST AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48906
Mailing Address - Country:US
Mailing Address - Phone:517-321-1530
Mailing Address - Fax:
Practice Address - Street 1:2201 NORTHWEST AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906
Practice Address - Country:US
Practice Address - Phone:517-321-1530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009953225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty