Healthcare Provider Details

I. General information

NPI: 1730776600
Provider Name (Legal Business Name): PEYTON STEELE DEAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2020
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5057 PINNACLE SQUARE
TRUSSVILLE AL
35235
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 205-655-9222
  • Fax: 205-655-9233
Mailing address:
  • Phone: 423-238-7217
  • Fax: 423-933-1996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH10230
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: