Provider Demographics
NPI:1760460711
Name:LEFTWICH, STEELE (PT)
Entity Type:Individual
Prefix:MR
First Name:STEELE
Middle Name:
Last Name:LEFTWICH
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 1:4100 SOUTHERN BLVD
Mailing Address - Street 2:SUITE 180-A
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-2073
Mailing Address - Country:US
Mailing Address - Phone:505-896-4978
Mailing Address - Fax:
Practice Address - Street 1:4100 SOUTHERN BLVD SE
Practice Address - Street 2:SUITE 180-A
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-2073
Practice Address - Country:US
Practice Address - Phone:505-896-4978
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2621225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist