Healthcare Provider Details
I. General information
NPI: 1770849895
Provider Name (Legal Business Name): STEEN CHIROPRACTIC CLINIC, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2012
Last Update Date: 04/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8999 SAINT CHARLES ROCK RD
SAINT LOUIS MO
63114-4260
US
IV. Provider business mailing address
8999 SAINT CHARLES ROCK RD
SAINT LOUIS MO
63114-4260
US
V. Phone/Fax
- Phone: 314-428-3343
- Fax: 314-428-3338
- Phone: 314-428-3343
- Fax: 314-428-3338
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KELLIE
STEEN
REED
Title or Position: PRESIDENT
Credential: D.C.
Phone: 314-428-3343