Provider Demographics
NPI:1588849269
Name:KILBAS, STEVEN RICHARD (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:RICHARD
Last Name:KILBAS
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 1:1075 E RIGGS RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-3685
Mailing Address - Country:US
Mailing Address - Phone:480-940-1991
Mailing Address - Fax:480-803-1912
Practice Address - Street 1:1075 E RIGGS RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-3685
Practice Address - Country:US
Practice Address - Phone:480-940-1991
Practice Address - Fax:480-803-1912
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor