Provider Demographics
NPI:1760846158
Name:STEELE, CARTER (DPT, CSCS)
Entity Type:Individual
Prefix:
First Name:CARTER
Middle Name:
Last Name:STEELE
Suffix:
Gender:M
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8092 W PARADISE LN
Mailing Address - Street 2:#3021
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-4976
Mailing Address - Country:US
Mailing Address - Phone:515-570-0853
Mailing Address - Fax:
Practice Address - Street 1:15543 N REEMS RD
Practice Address - Street 2:#133
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9582
Practice Address - Country:US
Practice Address - Phone:623-975-5374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12591225100000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist