Provider Demographics
NPI:1790671089
Name:OWENS, GRACE ELIZABETH (OD)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:ELIZABETH
Last Name:OWENS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 BLUE SPRING RD
Mailing Address - Street 2:
Mailing Address - City:DECHERD
Mailing Address - State:TN
Mailing Address - Zip Code:37324-3998
Mailing Address - Country:US
Mailing Address - Phone:931-307-3939
Mailing Address - Fax:
Practice Address - Street 1:1100 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2336
Practice Address - Country:US
Practice Address - Phone:931-393-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-14
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3949152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist