Provider Demographics
NPI:1104865450
Name:SCHWELNUS, STEELSON EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:STEELSON
Middle Name:EDWARD
Last Name:SCHWELNUS
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 1:153 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GOUVERNEUR
Mailing Address - State:NY
Mailing Address - Zip Code:13642-1552
Mailing Address - Country:US
Mailing Address - Phone:315-287-1070
Mailing Address - Fax:315-287-0290
Practice Address - Street 1:153 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GOUVERNEUR
Practice Address - State:NY
Practice Address - Zip Code:13642-1552
Practice Address - Country:US
Practice Address - Phone:315-287-1070
Practice Address - Fax:315-287-0290
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007934111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor