Provider Demographics
NPI:1366824450
Name:JOHANN L. TOWNE
Entity Type:Organization
Organization Name:JOHANN L. TOWNE
Other - Org Name:JOE L. TOWNE, CHIROPRACTIC PHYSICIAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHANN
Authorized Official - Middle Name:L
Authorized Official - Last Name:TOWNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-779-0235
Mailing Address - Street 1:945 TOWN CENTRE DR STE C
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6190
Mailing Address - Country:US
Mailing Address - Phone:541-779-0235
Mailing Address - Fax:541-816-4401
Practice Address - Street 1:945 TOWN CENTRE DR STE C
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6190
Practice Address - Country:US
Practice Address - Phone:541-779-0235
Practice Address - Fax:541-816-4401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2065111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR00WCJTMAMedicare PIN