Provider Demographics
NPI:1124198148
Name:VANHOOSER, STEVEN CRAIG (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CRAIG
Last Name:VANHOOSER
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 1:209 RUM RIVER DR. N
Mailing Address - Street 2:STE.2
Mailing Address - City:PRINCETON
Mailing Address - State:MN
Mailing Address - Zip Code:55371
Mailing Address - Country:US
Mailing Address - Phone:763-631-2225
Mailing Address - Fax:763-631-2226
Practice Address - Street 1:209 RUM RIVER DR. N
Practice Address - Street 2:STE. 2
Practice Address - City:PRINCETON
Practice Address - State:MN
Practice Address - Zip Code:55371
Practice Address - Country:US
Practice Address - Phone:763-631-2225
Practice Address - Fax:763-631-2226
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN40F52VAOtherBLUE CROSS BLUE SHEILD
MN39F16PROtherBLUE CROSS BLUE SHEILD
MNCC0219AOtherCHIRO CARE
MN359000498Medicare ID - Type Unspecified
MN82995VAMedicare UPIN