Provider Demographics
NPI:1881815710
Name:MANUEL, STEVEN FREDERICK (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:FREDERICK
Last Name:MANUEL
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 1:1103 TROWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5221
Mailing Address - Country:US
Mailing Address - Phone:517-487-2225
Mailing Address - Fax:763-427-3260
Practice Address - Street 1:1103 TROWBRIDGE RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5221
Practice Address - Country:US
Practice Address - Phone:517-487-2225
Practice Address - Fax:763-427-3260
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4289111N00000X
MI2301008046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN206915600Medicaid