Individual
TRAVIS OWEN CHARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
410 S NYE AVE, FREMONT, NE 68025-5548
(402) 616-7582
Mailing address
410 S NYE AVE, FREMONT, NE 68025-5548
(402) 616-7582
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
384
NE
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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