Provider Demographics
NPI:1194445163
Name:SMECK, STEPHEN PATRICK (DPT, PT)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:PATRICK
Last Name:SMECK
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 JUNE AVE
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-4168
Mailing Address - Country:US
Mailing Address - Phone:267-566-1721
Mailing Address - Fax:
Practice Address - Street 1:607 LOUIS DR
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-2843
Practice Address - Country:US
Practice Address - Phone:267-566-1721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030696225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist