MEDICARE: JOY ELIZABETH TOWNSEND CSAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	0710000368	VA

General Provider Information

NPI Number	:	1710425764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY ELIZABETH TOWNSEND CSAC

Provider Business Mailing Address
First Line	:	4212 CYPRESS PARK DR
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-8417
Country	:	US
Telephone Number	:	540-400-7841
Fax Number	:	540-400-8177

Provider Business Practice Location Address
First Line	:	4212 CYPRESS PARK DR
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-8417
Country	:	US
Telephone Number	:	540-400-7841
Fax Number	:	540-400-8177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2017
Last Update Date	:	02/09/2017

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