Provider Demographics
NPI:1649626987
Name:VANALSTINE-TAUER, VICTORIA M
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:M
Last Name:VANALSTINE-TAUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 SOUTHWICK RD
Mailing Address - Street 2:APT D2
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-4784
Mailing Address - Country:US
Mailing Address - Phone:303-525-1752
Mailing Address - Fax:
Practice Address - Street 1:342 SOUTHWICK RD
Practice Address - Street 2:APT D2
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-4784
Practice Address - Country:US
Practice Address - Phone:303-525-1752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer