Provider Demographics
NPI:1518556109
Name:STEADMAN, ERIC JACK (DPT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:JACK
Last Name:STEADMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 W 2540 N
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-3138
Mailing Address - Country:US
Mailing Address - Phone:801-884-2252
Mailing Address - Fax:
Practice Address - Street 1:3333 N DIGITAL DR STE 400
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-6695
Practice Address - Country:US
Practice Address - Phone:801-609-6034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2023-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9410431-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist