Provider Demographics
NPI:1346913100
Name:TOWN, CLAIRA HOPE
Entity Type:Individual
Prefix:MISS
First Name:CLAIRA
Middle Name:HOPE
Last Name:TOWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 S PROVIDENCE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-3645
Mailing Address - Country:US
Mailing Address - Phone:573-825-1601
Mailing Address - Fax:
Practice Address - Street 1:3211 S PROVIDENCE RD STE 105
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-3645
Practice Address - Country:US
Practice Address - Phone:573-825-1601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225700000X
MO2018045227225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist