Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | IL |
NPI | 1013073105 |
---|---|
Provider Name | Helen Owens |
First Address | Homer Glen, IL 60491-7847 |
Second Address | Homer Glen, IL 60491-7847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2006 |
Last Update Date | 08/07/2007 |