Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251X0800X | Physical Therapist - Orthopedic | 08798 | LA |
Y | 2251X0800X | Physical Therapist - Orthopedic | 31010 | FL |
NPI | 1023423407 |
---|---|
Provider Name | Dr. Steven Churchill |
First Address | Orlando, FL 32836-3721 |
Second Address | Orlando, FL 32837-7615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2014 |
Last Update Date | 04/12/2015 |