Provider Demographics
NPI:1104469204
Name:OWENS, ZACHARY THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:THOMAS
Last Name:OWENS
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 1:201 HARDING BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-2814
Mailing Address - Country:US
Mailing Address - Phone:916-784-2727
Mailing Address - Fax:916-784-3821
Practice Address - Street 1:201 HARDING BLVD STE J
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-2814
Practice Address - Country:US
Practice Address - Phone:916-784-2727
Practice Address - Fax:916-784-3821
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34665111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor