Healthcare Provider Details

I. General information

NPI: 1548358021
Provider Name (Legal Business Name): STEVEN TODD DEEHL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 N PINE ST
FENTON MI
48430-2166
US

IV. Provider business mailing address

106 N. PINE ST
FENTON MI
48423
US

V. Phone/Fax

Practice location:
  • Phone: 810-750-9303
  • Fax: 810-750-9339
Mailing address:
  • Phone: 810-750-9303
  • Fax: 810-750-9339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301004090
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: