Provider Demographics
NPI:1831390210
Name:TOWLE, RICHARD J (RDO)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:J
Last Name:TOWLE
Suffix:
Gender:M
Credentials:RDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MIDDLESEX TPKE
Mailing Address - Street 2:BURLINGTON MALL, 1103
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4923
Mailing Address - Country:US
Mailing Address - Phone:781-272-5621
Mailing Address - Fax:781-272-0416
Practice Address - Street 1:75 MIDDLESEX TPKE
Practice Address - Street 2:BURLINGTON MALL, 1103
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4923
Practice Address - Country:US
Practice Address - Phone:781-272-5621
Practice Address - Fax:781-272-0416
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4001156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician