Provider Demographics
NPI:1013100254
Name:STEELE, GEOFFREY LYN (MT)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:LYN
Last Name:STEELE
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 N 27TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-2310
Mailing Address - Country:US
Mailing Address - Phone:304-623-7800
Mailing Address - Fax:304-623-0706
Practice Address - Street 1:217 N 27TH ST
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-2310
Practice Address - Country:US
Practice Address - Phone:304-623-7800
Practice Address - Fax:304-623-0706
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist