MEDICARE: DR. JACOB RYAN STECKEL D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	B01306	NV

General Provider Information

NPI Number	:	1215243068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACOB RYAN STECKEL D.C.

Provider Business Mailing Address
First Line	:	PO BOX 36853
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-6853
Country	:	US
Telephone Number	:	702-644-3333
Fax Number	:	702-644-3336

Provider Business Practice Location Address
First Line	:	8678 SPRING MOUNTAIN RD
Second Line	:	STE 130
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-4112
Country	:	US
Telephone Number	:	702-384-0000
Fax Number	:	702-221-4853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2010
Last Update Date	:	01/31/2014

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