Provider Demographics
NPI:1982960217
Name:TOWNSEND, BRUCE A (ACA BC-HIS)
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:A
Last Name:TOWNSEND
Suffix:
Gender:M
Credentials:ACA BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-3550
Mailing Address - Country:US
Mailing Address - Phone:706-548-5245
Mailing Address - Fax:706-548-6533
Practice Address - Street 1:1650 W BROAD ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-0001
Practice Address - Country:US
Practice Address - Phone:706-548-5245
Practice Address - Fax:706-548-6533
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS000593174400000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No174400000XOther Service ProvidersSpecialist