Healthcare Provider Details

I. General information

NPI: 1629596432
Provider Name (Legal Business Name): KEITH STEFFES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2017
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 S OVERLAND RD
ONEIDA WI
54155-8959
US

IV. Provider business mailing address

PO BOX 365
ONEIDA WI
54155-0365
US

V. Phone/Fax

Practice location:
  • Phone: 920-869-2711
  • Fax: 920-869-1780
Mailing address:
  • Phone: 920-869-2711
  • Fax: 920-869-1780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2678-19
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: