Provider Demographics
NPI:1932527595
Name:OWENS PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:OWENS PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:980-297-1785
Mailing Address - Street 1:3907 EASTSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3104
Mailing Address - Country:US
Mailing Address - Phone:980-297-1785
Mailing Address - Fax:704-342-3393
Practice Address - Street 1:725 PROVIDENCE RD
Practice Address - Street 2:SUITE 205
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2370
Practice Address - Country:US
Practice Address - Phone:980-297-1785
Practice Address - Fax:704-342-3393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5372225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty