Provider Demographics
NPI:1881930881
Name:WENTZ, STEVEN J (DPT)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:WENTZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8073 WASHINGTON VILLAGE DR 110
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1847
Mailing Address - Country:US
Mailing Address - Phone:937-813-2110
Mailing Address - Fax:937-813-8025
Practice Address - Street 1:108 BARRINGTON TOWN SQUARE DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-7792
Practice Address - Country:US
Practice Address - Phone:330-562-1655
Practice Address - Fax:330-562-1653
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT014073225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist