Healthcare Provider Details

I. General information

NPI: 1427184985
Provider Name (Legal Business Name): STEFFANY LANDRUM PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 01/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 W DEWITT HENRY DR STE D
BEEBE AR
72012-2102
US

IV. Provider business mailing address

807 KAMAK DR
BEEBE AR
72012-2087
US

V. Phone/Fax

Practice location:
  • Phone: 501-882-2260
  • Fax: 501-882-2369
Mailing address:
  • Phone: 501-258-7944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT2924
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: