Individual
OWEN FILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
60007 W WAY DR, AMITE, LA 70422-4186
(985) 748-8096
(985) 748-4376
Mailing address
60007 W WAY DR, AMITE, LA 70422-4186
(985) 748-8096
(985) 748-4376
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1939-875AT
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1939-875AT
STATE LICENSE
LA
Enumeration date
07/20/2021
Last updated
07/20/2021
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