Healthcare Provider Details

I. General information

NPI: 1770741910
Provider Name (Legal Business Name): STEP BY STEP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 06/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 LONG LN
UPPER DARBY PA
19082-2500
US

IV. Provider business mailing address

67 LONG LN
UPPER DARBY PA
19082-2500
US

V. Phone/Fax

Practice location:
  • Phone: 610-265-2015
  • Fax:
Mailing address:
  • Phone: 610-265-2015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number130750
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number130750
License Number StatePA

VIII. Authorized Official

Name: MR. JAMES L BOBECK
Title or Position: CHIELF EXECUTIVE OFFICER
Credential:
Phone: 570-829-3477