Provider Demographics
NPI:1538571583
Name:STEVENTON, DANIEL JARED (DPT)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JARED
Last Name:STEVENTON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 E SPLIT ROCK RD
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-3954
Mailing Address - Country:US
Mailing Address - Phone:605-359-9210
Mailing Address - Fax:
Practice Address - Street 1:6301 E SPLIT ROCK RD
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-3954
Practice Address - Country:US
Practice Address - Phone:605-359-9210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1746225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist