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General NPI Number Information
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NPI Number | 1538689286
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Entity Type | Individual
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Provider Name | JACOB PAUL TOWERS I
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Gender | Male
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Dates
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Enumeration Date | 06/23/2017
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 714 AQUIDNECK AVE
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City | MIDDLETOWN
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State | RI
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Zip | 02842-5796
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Country | US
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Telephone | 401-414-5212
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Fax |
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Provider Business Mailing Address
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Address Line | 24 CEDAR POND DR APT 5
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City | WARWICK
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State | RI
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Zip | 02886-0847
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Country | US
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Telephone | 401-808-0882
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Fax | 401-808-0882
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA01466
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT00482
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License Number State | RI
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