Provider Demographics
NPI:1720228190
Name:PAISLEY, STEVEN ROBERT (LMT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ROBERT
Last Name:PAISLEY
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 1:3804 FISHINGER BLVD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9551
Mailing Address - Country:US
Mailing Address - Phone:614-777-2222
Mailing Address - Fax:
Practice Address - Street 1:3804 FISHINGER BLVD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9551
Practice Address - Country:US
Practice Address - Phone:614-777-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17276174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist