Provider Demographics
NPI:1437374063
Name:TOWERY, DAVID BASIL (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BASIL
Last Name:TOWERY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 JEFFERSON PARKWAY
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263
Mailing Address - Country:US
Mailing Address - Phone:770-251-3408
Mailing Address - Fax:770-251-3409
Practice Address - Street 1:12 JEFFERSON PARKWAY
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263
Practice Address - Country:US
Practice Address - Phone:770-251-3408
Practice Address - Fax:770-251-3409
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR004949111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCDFZMedicare UPIN