Provider Demographics
NPI:1750545851
Name:STEEL, JOHN ANDREW (PTA)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ANDREW
Last Name:STEEL
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9518 W LANTERN LN
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:IN
Mailing Address - Zip Code:46064-9468
Mailing Address - Country:US
Mailing Address - Phone:765-635-7058
Mailing Address - Fax:
Practice Address - Street 1:9518 W LANTERN LN
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:IN
Practice Address - Zip Code:46064-9468
Practice Address - Country:US
Practice Address - Phone:765-635-7058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06002354A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant