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General NPI Number Information
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NPI Number | 1942568712
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Entity Type | Individual
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Provider Name | STEVEN PATRICK MCQUISTON LMBT
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Gender | Male
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Dates
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Enumeration Date | 04/30/2012
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Last Update Date | 04/30/2012
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Provider Practice Location Address
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Address Line | 3008 NORTHLINE AVE
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City | GREENSBORO
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State | NC
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Zip | 27408-7816
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Country | US
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Telephone | 336-294-3223
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Fax |
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Provider Business Mailing Address
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Address Line | 4825 TOWER RD APT C
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City | GREENSBORO
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State | NC
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Zip | 27410-5818
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Country | US
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Telephone | 336-508-7336
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2021
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License Number State | NC
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