Provider Demographics
NPI:1649552639
Name:OWEN, CLARA REINA (LMT)
Entity type:Individual
Prefix:MS
First Name:CLARA
Middle Name:REINA
Last Name:OWEN
Suffix:
Gender:
Credentials:LMT
Other - Prefix:MRS
Other - First Name:CLARA
Other - Middle Name:REINA
Other - Last Name:OWEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:289 RODEO DR STE 3
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MT
Mailing Address - Zip Code:59833-6826
Mailing Address - Country:US
Mailing Address - Phone:406-546-7832
Mailing Address - Fax:
Practice Address - Street 1:289 RODEO DR STE 3
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MT
Practice Address - Zip Code:59833-6826
Practice Address - Country:US
Practice Address - Phone:406-546-7832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT482225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist