Provider Demographics
NPI:1508687054
Name:TOWNES, JIMMY L JR
Entity type:Individual
Prefix:
First Name:JIMMY
Middle Name:L
Last Name:TOWNES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 N GREENBAY ROAD
Mailing Address - Street 2:APT 216
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085
Mailing Address - Country:US
Mailing Address - Phone:262-504-0241
Mailing Address - Fax:
Practice Address - Street 1:206 N GREENBAY ROAD
Practice Address - Street 2:APT 216
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085
Practice Address - Country:US
Practice Address - Phone:262-504-0241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach