Healthcare Provider Details

I. General information

NPI: 1568650901
Provider Name (Legal Business Name): STEVEN RICHARD PINDER DPT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 10/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 CRILL AVE STE 3
PALATKA FL
32177-6807
US

IV. Provider business mailing address

529 KIRBY ST
PALATKA FL
32177-5133
US

V. Phone/Fax

Practice location:
  • Phone: 386-325-1119
  • Fax: 386-325-4326
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT20754
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: