Provider Demographics
NPI:1639141955
Name:STEELE, MARCUS ARNOLD (DC)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:ARNOLD
Last Name:STEELE
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 1:1218 ELLIS STREET
Mailing Address - Street 2:
Mailing Address - City:KEWAUNEE
Mailing Address - State:WI
Mailing Address - Zip Code:54216
Mailing Address - Country:US
Mailing Address - Phone:920-388-3440
Mailing Address - Fax:920-388-4560
Practice Address - Street 1:1218 ELLIS STREET
Practice Address - Street 2:STEELE CHIROPRACTIC CLINIC
Practice Address - City:KEWAUNEE
Practice Address - State:WI
Practice Address - Zip Code:54216
Practice Address - Country:US
Practice Address - Phone:920-388-3440
Practice Address - Fax:920-388-4560
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI391851240013OtherBCBS OF WI
WI38893000Medicaid
000170780Medicare PIN
U55354Medicare UPIN