Provider Demographics
NPI:1275527517
Name:STEFFENS, SCOTT T (DC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:T
Last Name:STEFFENS
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 1:704 11TH ST
Mailing Address - Street 2:
Mailing Address - City:DE WITT
Mailing Address - State:IA
Mailing Address - Zip Code:52742-1325
Mailing Address - Country:US
Mailing Address - Phone:563-659-9935
Mailing Address - Fax:563-659-3243
Practice Address - Street 1:704 11TH ST
Practice Address - Street 2:
Practice Address - City:DE WITT
Practice Address - State:IA
Practice Address - Zip Code:52742-1325
Practice Address - Country:US
Practice Address - Phone:563-659-9935
Practice Address - Fax:563-659-3243
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05146111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA24959Medicare ID - Type Unspecified