Provider Demographics
NPI:1336973551
Name:TOWNSEND, PAMELA JEAN (LMT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEAN
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1590 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-1833
Mailing Address - Country:US
Mailing Address - Phone:801-695-3982
Mailing Address - Fax:
Practice Address - Street 1:1590 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1833
Practice Address - Country:US
Practice Address - Phone:801-695-3982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10919554-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist