Provider Demographics
NPI:1942568712
Name:MCQUISTON, STEVEN PATRICK (LMBT)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:PATRICK
Last Name:MCQUISTON
Suffix:
Gender:M
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4825 TOWER RD APT C
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-5818
Mailing Address - Country:US
Mailing Address - Phone:336-508-7336
Mailing Address - Fax:
Practice Address - Street 1:3008 NORTHLINE AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7816
Practice Address - Country:US
Practice Address - Phone:336-294-3223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist