Healthcare Provider Details

I. General information

NPI: 1699815415
Provider Name (Legal Business Name): ANDREW CARY TOWLEN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 MASSACHUSETTS AVE SUITE 007
CAMBRIDGE MA
02140-1430
US

IV. Provider business mailing address

PO BOX 160
HAMILTON MA
01936-0160
US

V. Phone/Fax

Practice location:
  • Phone: 617-821-3379
  • Fax:
Mailing address:
  • Phone: 617-821-3379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number934
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: