Healthcare Provider Details

I. General information

NPI: 1578594792
Provider Name (Legal Business Name): MAURIE S STEINLEY PT, DSC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 06/25/2021
Certification Date: 06/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17599 KENWOOD TRL
LAKEVILLE MN
55044-8330
US

IV. Provider business mailing address

7825 3RD ST N STE 105
OAKDALE MN
55128-5444
US

V. Phone/Fax

Practice location:
  • Phone: 952-835-4512
  • Fax: 888-425-0398
Mailing address:
  • Phone: 952-835-4512
  • Fax: 888-425-0398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number5108
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: