Provider Demographics
NPI:1568687192
Name:OWUSU, BETHANY ANN (DC)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:ANN
Last Name:OWUSU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 HASLETT RD
Mailing Address - Street 2:STE A
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-8669
Mailing Address - Country:US
Mailing Address - Phone:517-853-2027
Mailing Address - Fax:517-853-0832
Practice Address - Street 1:2119 HASLETT RD
Practice Address - Street 2:STE A
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-8669
Practice Address - Country:US
Practice Address - Phone:517-853-2027
Practice Address - Fax:517-853-0832
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009327111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor