Provider Demographics
NPI:1033787684
Name:THOMAS, STEFFEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:STEFFEN
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10238 HAUSER ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-1854
Mailing Address - Country:US
Mailing Address - Phone:760-960-4075
Mailing Address - Fax:
Practice Address - Street 1:10238 HAUSER ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-1854
Practice Address - Country:US
Practice Address - Phone:760-960-4075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021033582225100000X
KS11-06679225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist