Provider Demographics
NPI:1114991981
Name:TOWNSLEY, WALTER CLAY (ATC/L)
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:CLAY
Last Name:TOWNSLEY
Suffix:
Gender:M
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 W ROSEDALE ST
Mailing Address - Street 2:SUITE 522
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-7438
Mailing Address - Country:US
Mailing Address - Phone:817-877-8977
Mailing Address - Fax:817-877-1106
Practice Address - Street 1:1550 W ROSEDALE ST
Practice Address - Street 2:SUITE 522
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-7438
Practice Address - Country:US
Practice Address - Phone:817-877-8977
Practice Address - Fax:817-877-1106
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT1352174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist