Provider Demographics
NPI:1235353566
Name:TOWNSEND, MELISSA D (SAC ST)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:D
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:SAC ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 FERN DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37323
Mailing Address - Country:US
Mailing Address - Phone:423-284-1724
Mailing Address - Fax:
Practice Address - Street 1:120 FERN DRIVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37323
Practice Address - Country:US
Practice Address - Phone:423-284-1724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist