Organization
STEPPIN UP PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON D HAZELETT DPT (PRESIDENT)
(260) 497-7191
Entity
Organization
Contact information
Practice address
9823 AUBURN RD, FORT WAYNE, IN 46825-2347
(260) 497-7191
(260) 497-7791
Mailing address
12844 COLDWATER RD STE B, FORT WAYNE, IN 46845-8833
(260) 497-7191
(260) 744-5586
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200496360A
—
IN
01
—
DD3722
MEDICARE RAILRAOD
IN
Enumeration date
12/16/2005
Last updated
06/07/2023
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