Provider Demographics
NPI:1508854365
Name:STEELE, CAROL L (RPT)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:STEELE
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-5004
Mailing Address - Country:US
Mailing Address - Phone:785-749-0130
Mailing Address - Fax:785-749-0132
Practice Address - Street 1:1305 WAKARUSA DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-3830
Practice Address - Country:US
Practice Address - Phone:785-842-3444
Practice Address - Fax:785-842-3410
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1102872225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100382950AMedicaid