Individual
MR. ANTHONY DEWAYNE TOWNSEND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1265 MCLARAN AVE, SAINT LOUIS, MO 63147-1606
(314) 388-4121
(314) 395-3103
Mailing address
4153 WASHINGTON BLVD, SAINT LOUIS, MO 63108-3134
(314) 315-2264
(314) 652-9500
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057.003235
IL
224Z00000X
Occupational Therapy Assistant
Primary
2010015742
MO
Other
Enumeration date
05/31/2012
Last updated
05/31/2012
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