=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518264571
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SMALL STEPS DEVELOPMENTAL LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2011
-----------------------------------------------------
Last Update Date | 02/27/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4882 ORTEN DR
-----------------------------------------------------
City | HOPKINSVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42240-9338
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-348-4470
-----------------------------------------------------
Fax | 270-886-6269
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4882 ORTEN DR
-----------------------------------------------------
City | HOPKINSVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42240-9338
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-348-4470
-----------------------------------------------------
Fax | 270-886-6269
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER/ PHYSICAL THERAPIST
-----------------------------------------------------
Name | MRS. HEATHER CAROL ROBINSON-CURTIS
-----------------------------------------------------
Credential | PT
-----------------------------------------------------
Telephone | 270-348-4470
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number | 002953
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------