Provider Demographics
NPI:1164508032
Name:STEELE CREEK PHYSICAL THERAPY & BALANCE CENTER INC
Entity Type:Organization
Organization Name:STEELE CREEK PHYSICAL THERAPY & BALANCE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORRISSETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:704-504-2194
Mailing Address - Street 1:PO BOX 38600
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-1010
Mailing Address - Country:US
Mailing Address - Phone:704-504-2194
Mailing Address - Fax:704-504-2197
Practice Address - Street 1:10965 WINDS CROSSING DR STE 300
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-2400
Practice Address - Country:US
Practice Address - Phone:704-504-2194
Practice Address - Fax:704-504-2197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC018XAOtherBCBS OF NC
NC7212120Medicaid
NC18646OtherEVOLUTIONS
NC195578OtherMEDCOST
NC560619329OtherTRICARE OUT OF NETWORK
NC2329828OtherMEDICARE NC
NC9455684OtherPHCS
SCTH1743Medicaid
NC2329828OtherMEDICARE NC
NC7212120Medicaid