Provider Demographics
NPI:1447660279
Name:MASCHMEYER, STEVEN EDWARD (CMTPT, LMT, BS)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:EDWARD
Last Name:MASCHMEYER
Suffix:
Gender:M
Credentials:CMTPT, LMT, BS
Other - Prefix:MR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:MASCHMEYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CMTPT, LMT, BS
Mailing Address - Street 1:10291 N MERIDIAN ST STE 170
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46290-1000
Mailing Address - Country:US
Mailing Address - Phone:317-658-4987
Mailing Address - Fax:317-973-0888
Practice Address - Street 1:10291 N MERIDIAN ST STE 170
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46290-1000
Practice Address - Country:US
Practice Address - Phone:317-973-0888
Practice Address - Fax:317-973-0888
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172M00000X, 225500000X
INMT21605940225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No172M00000XOther Service ProvidersMechanotherapist
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INMT21605940OtherINDIANA MASSAGE BOARD