Stacey M Owen, LPTA

Individual provider Active NPI Physical Therapy Assistant · Altavista, VA

NPI 1801353040 · NPPES record last updated Feb 25, 2019

Key facts

NPI
1801353040
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2306604926
Practice address
1317 Lola Ave
Altavista, VA 24517-1352
Phone
(434) 369-6651
NPI assigned
Feb 25, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306604926 Yes

Addresses

Primary practice location

1317 Lola Ave
Altavista, VA 24517-1352

Mailing address

105 Hillview Dr
Lynchburg, VA 24502-4107

Other providers in Altavista, VA

All providers in Altavista, VA · Physical Therapy Assistant in Virginia

Sources for this page

Verify at the official NPI Registry.