Provider Demographics
NPI:1184147167
Name:OWEN, WILLIAM JOHN JAMES (PT, DPT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOHN JAMES
Last Name:OWEN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BEAR BROOK RD
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07656-2001
Mailing Address - Country:US
Mailing Address - Phone:201-916-6537
Mailing Address - Fax:
Practice Address - Street 1:283 PIAGET AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2510
Practice Address - Country:US
Practice Address - Phone:973-772-3930
Practice Address - Fax:973-772-1498
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0260852251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic