Provider Demographics
NPI:1245258359
Name:FERDIG, STEVEN PAUL (MPT, OCS)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:PAUL
Last Name:FERDIG
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Gender:M
Credentials:MPT, OCS
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Mailing Address - Street 1:32 CAMPUS DR
Mailing Address - Street 2:SKAGGS BLDG#129
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59812-0001
Mailing Address - Country:US
Mailing Address - Phone:406-243-4006
Mailing Address - Fax:406-243-4303
Practice Address - Street 1:250 EL CAMINO REAL
Practice Address - Street 2:SUITE 100
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3655
Practice Address - Country:US
Practice Address - Phone:714-838-6999
Practice Address - Fax:714-838-7099
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2018-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPT19617225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WPT19617CMedicare ID - Type Unspecified