Individual
TONIA RENE OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 DEER CREEK WAY, CLINTON, MS 39056-4197
(160) 139-8536
Mailing address
107 DEER CREEK WAY, CLINTON, MS 39056-4197
(160) 139-8536
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800404522
DRIVERS LICENSE
MS
Enumeration date
03/22/2021
Last updated
03/22/2021
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