Provider Demographics
NPI:1619068731
Name:TOWLE, LISA MARIE FRANCEY (DC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MARIE FRANCEY
Last Name:TOWLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:M
Other - Last Name:FRANCEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:16 PARK ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617
Mailing Address - Country:US
Mailing Address - Phone:315-386-2273
Mailing Address - Fax:315-386-2274
Practice Address - Street 1:16 PARK ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617
Practice Address - Country:US
Practice Address - Phone:315-386-2273
Practice Address - Fax:315-386-2274
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0098311111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA5667Medicare PIN