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General NPI Number Information
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NPI Number | 1043309818
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Entity Type | Organization
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Legal Business Name | L J STEELE DC INC
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/06/2008
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Provider Practice Location Address
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Address Line | 1116 COLLEGE MALL ROAD
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City | BLOOMINGTON
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State | IN
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Zip | 47401-6178
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Country | US
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Telephone | 812-339-2095
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Fax | 812-339-5128
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Provider Business Mailing Address
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Address Line | 1116 COLLEGE MALL ROAD
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City | BLOOMINGTON
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State | IN
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Zip | 47401-6178
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Country | US
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Telephone | 812-339-2095
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Fax | 812-339-5128
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Authorized Official
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Title or Position | PRESIDENT
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Name | LARRY J STEELE
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Credential | D.C.
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Telephone | 812-339-2095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 08000365A
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License Number State | IN
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