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General NPI Number Information
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NPI Number | 1669529962
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Entity Type | Individual
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Provider Name | STEVEN JOSEPH O'DONNELL DC
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Gender | Male
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 74 S BROAD ST
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City | MERIDEN
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State | CT
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Zip | 06450-6545
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Country | US
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Telephone | 203-235-0171
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Fax | 203-235-3310
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Provider Business Mailing Address
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Address Line | 1655 N COLONY RD #3005
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City | MERIDEN
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State | CT
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Zip | 06450-1900
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Country | US
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Telephone | 203-235-0171
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Fax | 203-235-3310
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 000854
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License Number State | CT
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