Provider Demographics
NPI:1275647547
Name:TOWLE, DEBORAH R (DC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:R
Last Name:TOWLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11260 DONNER PASS RD # 171
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-4848
Mailing Address - Country:US
Mailing Address - Phone:530-587-0705
Mailing Address - Fax:530-587-4875
Practice Address - Street 1:11630 BROOK LN.
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-4847
Practice Address - Country:US
Practice Address - Phone:530-587-0705
Practice Address - Fax:530-587-4875
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18020111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFF084AMedicare PIN