Provider Demographics
NPI:1841883378
Name:FUTURE STEPS PEDIATRICS LLC
Entity type:Organization
Organization Name:FUTURE STEPS PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:TARDY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:803-556-2593
Mailing Address - Street 1:105D SERENDIPITY WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-6979
Mailing Address - Country:US
Mailing Address - Phone:803-556-2593
Mailing Address - Fax:803-832-1499
Practice Address - Street 1:105D SERENDIPITY WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-6979
Practice Address - Country:US
Practice Address - Phone:803-556-2593
Practice Address - Fax:803-832-1499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty