Provider Demographics
NPI:1992842223
Name:TOWLE, MATTHEW E (ATC)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:E
Last Name:TOWLE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2354 POLO PARK DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45439-3271
Mailing Address - Country:US
Mailing Address - Phone:937-395-0843
Mailing Address - Fax:
Practice Address - Street 1:5491 FAR HILLS AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-2325
Practice Address - Country:US
Practice Address - Phone:937-436-5763
Practice Address - Fax:937-436-7399
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT 001272174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist