Provider Demographics
NPI:1962444331
Name:OWENS, BRIAN (PT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:OWENS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5885 SUNNYBROOK DR
Mailing Address - Street 2:SUITE E-100
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-4203
Mailing Address - Country:US
Mailing Address - Phone:712-266-2700
Mailing Address - Fax:712-266-2719
Practice Address - Street 1:5885 SUNNYBROOK DR
Practice Address - Street 2:SUITE E-100
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4203
Practice Address - Country:US
Practice Address - Phone:712-266-2700
Practice Address - Fax:712-266-2719
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1023225100000X
NE1208225100000X
SD1160225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist