Provider Demographics
NPI:1548480833
Name:STEAKLEY, WILLIAM JEREMY (ATC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JEREMY
Last Name:STEAKLEY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1968 STONEHENGE AVE
Mailing Address - Street 2:APT. 11
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-5735
Mailing Address - Country:US
Mailing Address - Phone:931-607-8151
Mailing Address - Fax:
Practice Address - Street 1:1605 AVENUE OF CHAMPIONS
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101
Practice Address - Country:US
Practice Address - Phone:270-745-2617
Practice Address - Fax:270-745-2414
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer