Provider Demographics
NPI:1255545273
Name:TOWLE FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:TOWLE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:TOWLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:518-483-6300
Mailing Address - Street 1:PO BOX 183
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-0183
Mailing Address - Country:US
Mailing Address - Phone:518-483-6300
Mailing Address - Fax:518-483-6301
Practice Address - Street 1:3276 STATE ROUTE 11
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-4709
Practice Address - Country:US
Practice Address - Phone:518-483-6300
Practice Address - Fax:518-483-6301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011079111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherCHIROPRACTOR
NY=========OtherCHIROPRACTOR
NYBA 0586Medicare ID - Type UnspecifiedCHRIOPRACTOR