Provider Demographics
NPI:1982924395
Name:BREWSTER, OWEN ALOIS (DC)
Entity Type:Individual
Prefix:DR
First Name:OWEN
Middle Name:ALOIS
Last Name:BREWSTER
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 1:88 RHYNDERS RD
Mailing Address - Street 2:
Mailing Address - City:STAATSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12580-6248
Mailing Address - Country:US
Mailing Address - Phone:845-489-3516
Mailing Address - Fax:
Practice Address - Street 1:88 RHYNDERS RD
Practice Address - Street 2:
Practice Address - City:STAATSBURG
Practice Address - State:NY
Practice Address - Zip Code:12580-6248
Practice Address - Country:US
Practice Address - Phone:845-489-3516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-08
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012027111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor