Healthcare Provider Details

I. General information

NPI: 1487796157
Provider Name (Legal Business Name): STEEL CHIROPRACTIC CLINIC P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 PIERSON DR
CHARLOTTE NC
28205-6445
US

IV. Provider business mailing address

1409 PIERSON DR
CHARLOTTE NC
28205-6445
US

V. Phone/Fax

Practice location:
  • Phone: 704-563-5001
  • Fax: 704-563-5072
Mailing address:
  • Phone: 704-563-5001
  • Fax: 704-563-5072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number1381
License Number StateNC

VIII. Authorized Official

Name: MR. EDWARD JOSEPH STEEL
Title or Position: PRESIDENT
Credential: D.C.
Phone: 704-563-5001