Provider Demographics
NPI:1316676414
Name:STEELE, MARK
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:STEELE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BARKINGHAM LN STE C
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5905
Mailing Address - Country:US
Mailing Address - Phone:864-881-1712
Mailing Address - Fax:864-435-9923
Practice Address - Street 1:11 BARKINGHAM LN STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5905
Practice Address - Country:US
Practice Address - Phone:648-811-7128
Practice Address - Fax:864-435-9923
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12151225100000X
GAPT015957225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist