Provider Demographics
NPI:1093055451
Name:JAMES-OWENS, JOANNA DELORIS (PTA)
Entity type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:DELORIS
Last Name:JAMES-OWENS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 BOUNDARY ST
Mailing Address - Street 2:APT 15
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-3356
Mailing Address - Country:US
Mailing Address - Phone:843-340-3068
Mailing Address - Fax:
Practice Address - Street 1:1118 BOUNDARY ST
Practice Address - Street 2:APT 15
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-3356
Practice Address - Country:US
Practice Address - Phone:843-340-3068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003069225200000X
SC2471225200000X
NC5359225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant