Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 2403 | SC |
NPI | 1154479202 |
---|---|
Provider Name | Dr. Jennifer S. Owens |
First Address | Easley, SC 29640 |
Second Address | Easley, SC 29640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 30/04/2020 |