Provider Demographics
NPI:1972528362
Name:OWENS, SCOTT G (DC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:G
Last Name:OWENS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 FRANCISCO CT
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-7581
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 HARDING BLVD
Practice Address - Street 2:SUITE J
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-2814
Practice Address - Country:US
Practice Address - Phone:916-784-2727
Practice Address - Fax:916-784-3821
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19344111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor