Provider Demographics
NPI:1649789033
Name:OWEN, ANDREW JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JAMES
Last Name:OWEN
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:PO BOX 341
Mailing Address - Street 2:
Mailing Address - City:MILLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:12545-0341
Mailing Address - Country:US
Mailing Address - Phone:845-705-1186
Mailing Address - Fax:
Practice Address - Street 1:1134 KILDAIRE FARM ROAD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511
Practice Address - Country:US
Practice Address - Phone:919-467-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No111N00000XChiropractic ProvidersChiropractor