Provider Demographics
NPI:1720077266
Name:PETER A. TOWNE PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:PETER A. TOWNE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF QA/MKTG
Authorized Official - Prefix:MISS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:COULTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-863-3230
Mailing Address - Street 1:3734 CITATION DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-8006
Mailing Address - Country:US
Mailing Address - Phone:513-863-3230
Mailing Address - Fax:513-863-7701
Practice Address - Street 1:1390 EATON AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-1407
Practice Address - Country:US
Practice Address - Phone:513-863-2215
Practice Address - Fax:513-863-3338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH529261QP2000X
OH936261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Not Answered261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH36-6644Medicare ID - Type UnspecifiedMEDICARE PROVIDER #