Provider Demographics
NPI:1609590934
Name:TOWNE, BETHANY (LMT)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:TOWNE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 MAPLE ST APT 3R
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-5965
Mailing Address - Country:US
Mailing Address - Phone:484-542-7270
Mailing Address - Fax:
Practice Address - Street 1:1616 MAPLE ST APT 3R
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-5965
Practice Address - Country:US
Practice Address - Phone:484-542-7270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG013365225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty