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General NPI Number Information
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NPI Number | 1689789117
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Entity Type | Individual
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Provider Name | STEVEN KIM SIDEBOTTOM D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 11/22/2013
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Provider Practice Location Address
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Address Line | 293 COLLEGE PKWY
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City | PARKERSBURG
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State | WV
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Zip | 26104-7655
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Country | US
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Telephone | 304-485-1251
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Fax | 304-485-0306
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Provider Business Mailing Address
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Address Line | 293 COLLEGE PKWY
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City | PARKERSBURG
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State | WV
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Zip | 26104-7655
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Country | US
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Telephone | 304-485-1251
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Fax | 304-485-0306
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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 | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number | 306
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License Number State | WV
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