Provider Demographics
NPI:1245230564
Name:QUERIO, STEVEN J (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:QUERIO
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 1:2108 KOHLER MEMORIAL DR
Mailing Address - Street 2:#101
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-3100
Mailing Address - Country:US
Mailing Address - Phone:920-451-8142
Mailing Address - Fax:920-451-8159
Practice Address - Street 1:1747 SHAWANO AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-3261
Practice Address - Country:US
Practice Address - Phone:920-451-8142
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2948-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U42585Medicare UPIN