Provider Demographics
NPI:1407486608
Name:KNOWLES, STEVEN DONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DONALD
Last Name:KNOWLES
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 1:15 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04473-3652
Mailing Address - Country:US
Mailing Address - Phone:207-866-7000
Mailing Address - Fax:
Practice Address - Street 1:15 FOREST AVE
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04473-3652
Practice Address - Country:US
Practice Address - Phone:207-866-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR2626111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MECR2626OtherCHIROPRACTOR LICENSE