Provider Demographics
NPI:1033188305
Name:CONNELL, STERLING J (DC)
Entity Type:Individual
Prefix:DR
First Name:STERLING
Middle Name:J
Last Name:CONNELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 TOWNLEE LN # C
Mailing Address - Street 2:
Mailing Address - City:LUGOFF
Mailing Address - State:SC
Mailing Address - Zip Code:29078-8989
Mailing Address - Country:US
Mailing Address - Phone:803-408-9971
Mailing Address - Fax:
Practice Address - Street 1:20 TOWNLEE LN # C
Practice Address - Street 2:
Practice Address - City:LUGOFF
Practice Address - State:SC
Practice Address - Zip Code:29078-8989
Practice Address - Country:US
Practice Address - Phone:803-408-9971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU64550281Medicare UPIN