Provider Demographics
NPI:1932449972
Name:TRAYNOR, STEVEN PATRICK (PT, MPT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:PATRICK
Last Name:TRAYNOR
Suffix:
Gender:M
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-362-8684
Practice Address - Street 1:2603 N PLEASANTBURG DR
Practice Address - Street 2:UNIT D
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-3030
Practice Address - Country:US
Practice Address - Phone:864-298-0333
Practice Address - Fax:864-294-0454
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4443225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4443OtherLICENSE NUMBER