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General NPI Number Information
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NPI Number | 1366634818
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Entity Type | Organization
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Legal Business Name | MARYVILLE CHIROPRACTIC, PC
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 08/17/2007
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Provider Practice Location Address
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Address Line | 1626 E 1ST ST
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City | MARYVILLE
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State | MO
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Zip | 64468-3104
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Country | US
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Telephone | 660-582-8511
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Fax | 660-582-8511
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Provider Business Mailing Address
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Address Line | 1626 E 1ST ST
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City | MARYVILLE
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State | MO
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Zip | 64468-3104
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Country | US
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Telephone | 660-582-8511
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Fax | 660-582-8511
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Authorized Official
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Title or Position | CEO
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Name | DR. DOUGLAS H STEINER
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Credential | DC
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Telephone | 660-582-8511
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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 | 006710
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License Number State | MO
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