Provider Demographics
NPI:1265558373
Name:O, STEVE K (PT, LAC, CWS)
Entity type:Individual
Prefix:MR
First Name:STEVE
Middle Name:K
Last Name:O
Suffix:
Gender:M
Credentials:PT, LAC, CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1349 W CHELTENHAM AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-3141
Mailing Address - Country:US
Mailing Address - Phone:267-408-9294
Mailing Address - Fax:
Practice Address - Street 1:1349 W CHELTENHAM AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-3141
Practice Address - Country:US
Practice Address - Phone:267-408-9294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016630225100000X
PAAK000999171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171100000XOther Service ProvidersAcupuncturist