Individual
JIMMIE OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2331 WATKINS ST, PHILADELPHIA, PA 19145-1828
(215) 910-9343
Mailing address
2331 WATKINS ST, PHILADELPHIA, PA 19145-1828
(215) 910-9343
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093136202
—
MN
Enumeration date
03/01/2018
Last updated
03/01/2018
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