Individual
CHARLES GREGORY OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4833 SW 91ST TER, SUITE O-102, GAINESVILLE, FL 32608-9109
(352) 258-8727
Mailing address
707 NW 19TH AVE, GAINESVILLE, FL 32609-3559
(352) 258-8727
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA52087
FL
Other
Enumeration date
08/18/2009
Last updated
08/18/2009
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