Provider Demographics
NPI:1407900665
Name:STEPP, DANNY PATRICK (MPT)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:PATRICK
Last Name:STEPP
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14244 WATALULA RD
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AR
Mailing Address - Zip Code:72949-9269
Mailing Address - Country:US
Mailing Address - Phone:479-209-3616
Mailing Address - Fax:479-667-2706
Practice Address - Street 1:14244 WATALULA RD
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AR
Practice Address - Zip Code:72949-9269
Practice Address - Country:US
Practice Address - Phone:479-209-3616
Practice Address - Fax:479-667-2706
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2519225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR142664721Medicaid
AR5V891F466OtherMEDICARE PTAN