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General NPI Number Information
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NPI Number | 1679237200
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Entity Type | Individual
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Provider Name | STEVEN GREGORY PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 10/29/2021
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Last Update Date | 10/29/2021
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Provider Practice Location Address
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Address Line | 120 CYPRESS EDGE DR STE 101
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City | PALM COAST
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State | FL
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Zip | 32164-8454
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Country | US
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Telephone | 386-586-1691
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Fax | 386-586-1691
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Provider Business Mailing Address
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Address Line | 9475B COUNTY ROAD 13 N
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-2606
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Country | US
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Telephone | 904-347-1293
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State | FL
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