Provider Demographics
NPI:1588653265
Name:KAISEE, STEVEN A (PT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:KAISEE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104C OLD LAS VEGAS HWY
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-8199
Mailing Address - Country:US
Mailing Address - Phone:505-992-4995
Mailing Address - Fax:505-992-4985
Practice Address - Street 1:104C OLD LAS VEGAS HWY
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-8199
Practice Address - Country:US
Practice Address - Phone:505-992-4995
Practice Address - Fax:505-992-4985
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist