NPI 1235614231

Marcus Owens, LATATC

Practitioner Athletic Trainer Leesburg, VA

Practice location

Address: 520 Evergreen Mill Rd SE, Leesburg, VA 20175-8726
Phone: (571) 252-2800
Mailing address: 2229 Double Eagle CT, Reston, VA 20191-2401

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 0126001824 (VA)

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Registry record

NPI: 1235614231
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Sep 2018
Record last updated: 26 Sep 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.