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NPI Code Detail

MEDICARE: PROF. STEFFANY LANDRUM PT, DPT

MEDICARE:  PROF. STEFFANY  LANDRUM  PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT2924AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427184985
Entity Type Code : Individual
Provider Name (Legal Business Name) : PROF. STEFFANY LANDRUM PT, DPT
Provider Business Mailing Address
First Line : 807 KAMAK DR
Second Line :
City : BEEBE
State : AR
Zip : 72012-2087
Country : US
Telephone Number : 501-258-7944
Fax Number :
Provider Business Practice Location Address
First Line : 710 W DEWITT HENRY DR STE D
Second Line :
City : BEEBE
State : AR
Zip : 72012-2102
Country : US
Telephone Number : 501-882-2260
Fax Number : 501-882-2369
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 01/23/2014

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Directions to “ PROF. STEFFANY LANDRUM PT, DPT” Practice Location

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