Provider Demographics
NPI:1467546663
Name:IRVINE, STEVEN BRUCE (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:BRUCE
Last Name:IRVINE
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 1:1219 COUNTY LINE ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-6001
Mailing Address - Country:US
Mailing Address - Phone:614-839-2225
Mailing Address - Fax:614-891-8875
Practice Address - Street 1:1219 COUNTY LINE ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-6001
Practice Address - Country:US
Practice Address - Phone:614-839-2225
Practice Address - Fax:614-891-8875
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2727111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000122734OtherBLUE CROSS/BLUE SHIELD
OH2255-036Medicaid
OH000000122734OtherBLUE CROSS/BLUE SHIELD
OH2255-036Medicaid