Provider Demographics
NPI:1558521427
Name:AMY B. TOWNLEY DC., INC.
Entity Type:Organization
Organization Name:AMY B. TOWNLEY DC., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:TOWNLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:937-293-5300
Mailing Address - Street 1:1364 E STROOP RD
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-4926
Mailing Address - Country:US
Mailing Address - Phone:937-293-5300
Mailing Address - Fax:937-293-7055
Practice Address - Street 1:1364 E STROOP RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-4926
Practice Address - Country:US
Practice Address - Phone:937-293-5300
Practice Address - Fax:937-293-7055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1596311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0788027Medicaid
OHTO0664522Medicare PIN
OH0788027Medicaid