Provider Demographics
NPI:1598042236
Name:CHOUINARD, STEVEN RICHARD (ATC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:RICHARD
Last Name:CHOUINARD
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 1:13 OAK DR
Mailing Address - Street 2:REID ATHLETIC CENTER
Mailing Address - City:HAMILTON
Mailing Address - State:NY
Mailing Address - Zip Code:13346-1338
Mailing Address - Country:US
Mailing Address - Phone:315-228-7578
Mailing Address - Fax:
Practice Address - Street 1:13 OAK DR
Practice Address - Street 2:REID ATHLETIC CENTER
Practice Address - City:HAMILTON
Practice Address - State:NY
Practice Address - Zip Code:13346-1338
Practice Address - Country:US
Practice Address - Phone:315-228-7578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY74354472255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer