Provider Demographics
NPI:1265470157
Name:STEFFENS, TODD MICHAEL (PT, MPT)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:MICHAEL
Last Name:STEFFENS
Suffix:
Gender:M
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:1741 NE DOUGLAS ST STE 202
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-4705
Practice Address - Country:US
Practice Address - Phone:816-246-2672
Practice Address - Fax:816-246-2676
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003024607225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
33021116OtherBCBS KC
MOMA4370023OtherMEDICARE PTAN