Provider Demographics
NPI:1225383565
Name:STECKELBERG, ELIZABETH BARBARA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BARBARA
Last Name:STECKELBERG
Suffix:
Gender:F
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:PO BOX 141
Mailing Address - Street 2:
Mailing Address - City:GRAND MARAIS
Mailing Address - State:MN
Mailing Address - Zip Code:55604-0141
Mailing Address - Country:US
Mailing Address - Phone:218-370-2292
Mailing Address - Fax:
Practice Address - Street 1:110 6TH AVE. W
Practice Address - Street 2:
Practice Address - City:GRAND MARAIS
Practice Address - State:MN
Practice Address - Zip Code:55604-5560
Practice Address - Country:US
Practice Address - Phone:218-370-2292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8993225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist