MEDICARE: MRS. SANDRA DENISE STEELE P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2257	TN

General Provider Information

NPI Number	:	1023220449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANDRA DENISE STEELE P.T.

Provider Business Mailing Address
First Line	:	6096 HAGARS GROVE PASS
Second Line	:
City	:	HERMITAGE
State	:	TN
Zip	:	37076-5603
Country	:	US
Telephone Number	:	615-516-8822
Fax Number	:

Provider Business Practice Location Address
First Line	:	1430 W BADDOUR PKWY STE C
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087-2656
Country	:	US
Telephone Number	:	615-453-1422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2007
Last Update Date	:	05/12/2023

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