Healthcare Provider Details

I. General information

NPI: 1912183351
Provider Name (Legal Business Name): LARRY ALLEN STEFFENSMEIER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 WINSTON DRIVE
ROCK SPRINGS WY
82901-5727
US

IV. Provider business mailing address

215 WINSTON DRIVE
ROCK SPRINGS WY
82901-5727
US

V. Phone/Fax

Practice location:
  • Phone: 307-382-3090
  • Fax: 307-362-1024
Mailing address:
  • Phone: 307-382-3090
  • Fax: 307-362-1024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number507
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number507
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: