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General NPI Number Information
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NPI Number | 1932348208
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Entity Type | Individual
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Provider Name | PHILIP STECKLEY ATC
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Gender | Male
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 260 COOPER RD
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City | ROCHESTER
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State | NY
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Zip | 14617
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Country | US
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Telephone | 585-336-3150
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Fax |
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Provider Business Mailing Address
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Address Line | 67 BELMEADE RD.
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City | ROCHESTER
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State | NY
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Zip | 14617
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Country | US
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Telephone |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 000317-1
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License Number State | NY
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