Provider Demographics
NPI:1518294370
Name:STEELE, JESSICA A (PT)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:A
Last Name:STEELE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 BEAU RIVAGE DR
Mailing Address - Street 2:
Mailing Address - City:CRUMPLER
Mailing Address - State:NC
Mailing Address - Zip Code:28617-9616
Mailing Address - Country:US
Mailing Address - Phone:336-982-4080
Mailing Address - Fax:
Practice Address - Street 1:154 BEAU RIVAGE DR
Practice Address - Street 2:
Practice Address - City:CRUMPLER
Practice Address - State:NC
Practice Address - Zip Code:28617-9616
Practice Address - Country:US
Practice Address - Phone:336-982-4080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-15
Last Update Date:2009-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11607225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist