Provider Demographics
NPI:1831826478
Name:OWENS, DOUGLAS MCKAY (DC, ATC)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:MCKAY
Last Name:OWENS
Suffix:
Gender:M
Credentials:DC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 W 100 N
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-1402
Mailing Address - Country:US
Mailing Address - Phone:385-242-2744
Mailing Address - Fax:
Practice Address - Street 1:865 N 900 W
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-7701
Practice Address - Country:US
Practice Address - Phone:385-985-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10295433-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor