Provider Demographics
NPI:1710189626
Name:TOWNSEND, STEVEN R (LMT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12110 VAUGHN ST
Mailing Address - Street 2:
Mailing Address - City:EAST CONCORD
Mailing Address - State:NY
Mailing Address - Zip Code:14055-9754
Mailing Address - Country:US
Mailing Address - Phone:716-592-5425
Mailing Address - Fax:
Practice Address - Street 1:56 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-1223
Practice Address - Country:US
Practice Address - Phone:716-592-3187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009593-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist