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General NPI Number Information
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NPI Number | 1356328371
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Entity Type | Individual
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Provider Name | STEVEN RAY PRENTICE DC
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Gender | Male
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 1723 COLUMBUS AVENUE SUITE B
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City | SANDUSKY
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State | OH
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Zip | 44870
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Country | US
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Telephone | 419-621-7555
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Fax | 419-621-5597
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Provider Business Mailing Address
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Address Line | 1723 COLUMBUS AVENUE SUITE B
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City | SANDUSKY
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State | OH
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Zip | 44870
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Country | US
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Telephone | 419-621-7555
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Fax | 419-621-5597
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2262
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License Number State | OH
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