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Individual

LANCE M OWENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2215 44TH ST SW, WYOMING, MI 49519-6439
(616) 252-8300
(616) 252-8460
Mailing address
5900 BYRON CENTER AVE SW, ATTN: MEDICAL ADMINISTRATION, WYOMING, MI 49519-9606

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101013832
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08-5-41-1062-5
BCBS PIN
MI
05
1548224728
MI
Enumeration date
04/14/2006
Last updated
12/01/2017
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