Healthcare Provider Details

I. General information

NPI: 1043296510
Provider Name (Legal Business Name): STEPPIN UP PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9823 AUBURN RD
FORT WAYNE IN
46825-2347
US

IV. Provider business mailing address

12844 COLDWATER RD STE B
FORT WAYNE IN
46845-8833
US

V. Phone/Fax

Practice location:
  • Phone: 260-497-7191
  • Fax: 260-497-7791
Mailing address:
  • Phone: 260-497-7191
  • Fax: 260-744-5586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateIN

VIII. Authorized Official

Name: JASON HAZELETT
Title or Position: OWNER
Credential:
Phone: 260-497-7191