Healthcare Provider Details

I. General information

NPI: 1336283845
Provider Name (Legal Business Name): JANET TOWNSLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1152 OCEAN BLVD
MOUNTAIN VIEW AR
72560-8320
US

IV. Provider business mailing address

1152 OCEAN BLVD
MOUNTAIN VIEW AR
72560-8320
US

V. Phone/Fax

Practice location:
  • Phone: 870-269-7529
  • Fax: 870-269-2840
Mailing address:
  • Phone: 870-269-3567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberOTR439
License Number StateAR

VIII. Authorized Official

Name: JAN TOWNSLEY
Title or Position: OWNER
Credential: OTRL
Phone: 870-269-3567