Provider Demographics
NPI:1871829259
Name:LINVILLE, CLAUDIENNE ELIZABETH (PTA)
Entity type:Individual
Prefix:
First Name:CLAUDIENNE
Middle Name:ELIZABETH
Last Name:LINVILLE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 HAMILTON DR
Mailing Address - Street 2:APT 1
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4740
Mailing Address - Country:US
Mailing Address - Phone:716-903-9552
Mailing Address - Fax:
Practice Address - Street 1:11390 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1017
Practice Address - Country:US
Practice Address - Phone:716-580-3040
Practice Address - Fax:716-580-3042
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007245-1172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist