Provider Demographics
NPI:1902023401
Name:OWENS, RENEA LOUISE (PT)
Entity Type:Individual
Prefix:MS
First Name:RENEA
Middle Name:LOUISE
Last Name:OWENS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5633 OLDWYNNE RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9507
Mailing Address - Country:US
Mailing Address - Phone:614-774-8447
Mailing Address - Fax:614-293-5220
Practice Address - Street 1:2050 KENNY RD
Practice Address - Street 2:ROOM 2102
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3502
Practice Address - Country:US
Practice Address - Phone:614-293-6821
Practice Address - Fax:614-293-5220
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-5611225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5611OtherPT LICENSE NUMBER