Individual
DR. KELLY L OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1350 E MAIN ST STE 20, CLARION, PA 16214-6278
(814) 226-4862
(814) 226-8741
Mailing address
1350 E MAIN ST STE 20, CLARION, PA 16214-6278
(814) 226-4862
(814) 226-8741
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG003160
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6007380001
MEDICARE PTAN
PA
Enumeration date
06/22/2016
Last updated
11/10/2016
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