Provider Demographics
NPI:1356802391
Name:STECKLEIN, KASSIDY (DPT)
Entity type:Individual
Prefix:
First Name:KASSIDY
Middle Name:
Last Name:STECKLEIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 VINE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-1907
Mailing Address - Country:US
Mailing Address - Phone:785-628-2105
Mailing Address - Fax:785-628-2165
Practice Address - Street 1:2707 VINE ST STE 1
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-1907
Practice Address - Country:US
Practice Address - Phone:785-628-2105
Practice Address - Fax:785-628-2165
Is Sole Proprietor?:No
Enumeration Date:2019-03-30
Last Update Date:2019-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist