Healthcare Provider Details

I. General information

NPI: 1821266750
Provider Name (Legal Business Name): TOBIE J STEELE ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 WILLOW ST
VINCENNES IN
47591-5355
US

IV. Provider business mailing address

2121 WILLOW ST
VINCENNES IN
47591-5355
US

V. Phone/Fax

Practice location:
  • Phone: 812-882-1141
  • Fax: 812-255-0045
Mailing address:
  • Phone: 812-882-1141
  • Fax: 812-255-0045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number36001189A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: