Provider Demographics
NPI:1568017135
Name:CREAMER, STEPHEN (ATC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:CREAMER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 TAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-1017
Mailing Address - Country:US
Mailing Address - Phone:508-415-6316
Mailing Address - Fax:
Practice Address - Street 1:9 TAYLOR DR
Practice Address - Street 2:
Practice Address - City:RUMFORD
Practice Address - State:RI
Practice Address - Zip Code:02916-1017
Practice Address - Country:US
Practice Address - Phone:508-415-6316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAT004222255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer