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NPI 1689675977

NPI 1689675977 : STEVEN LEE EDDY DC : WILLIAMSTOWN, WV

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General NPI Number Information
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    NPI Number           |    1689675977
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    Entity Type          |    Individual 
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    Provider Name        |    STEVEN LEE EDDY DC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/09/2005
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    Last Update Date     |    06/13/2013
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Provider Practice Location Address
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    Address Line         |    443 HIGHLAND AVE 
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    City                 |    WILLIAMSTOWN
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    State                |    WV
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    Zip                  |    26187-1247
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    Country              |    US
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    Telephone            |    304-375-6000
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    Fax                  |    304-375-6043
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Provider Business Mailing Address
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    Address Line         |    443 HIGHLAND AVE 
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    City                 |    WILLIAMSTOWN
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    State                |    WV
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    Zip                  |    26187-1247
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    Country              |    US
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    Telephone            |    304-375-6000
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    Fax                  |    304-375-6043
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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       |    575
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    License Number State |    WV
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