Provider Demographics
NPI:1568809697
Name:STECKER, THOMAS PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PATRICK
Last Name:STECKER
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 1:109 BUSHAWAY RD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-1945
Mailing Address - Country:US
Mailing Address - Phone:952-746-5351
Mailing Address - Fax:952-746-5097
Practice Address - Street 1:109 BUSHAWAY RD
Practice Address - Street 2:SUITE #100
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-1945
Practice Address - Country:US
Practice Address - Phone:952-746-5351
Practice Address - Fax:952-746-5097
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5771111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor