Provider Demographics
NPI:1972647915
Name:STEELE, MATTHEW ARON (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ARON
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 1:1367 19.5 ST.
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:WI
Mailing Address - Zip Code:54822
Mailing Address - Country:US
Mailing Address - Phone:715-458-0406
Mailing Address - Fax:
Practice Address - Street 1:935 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54868
Practice Address - Country:US
Practice Address - Phone:715-736-2120
Practice Address - Fax:715-736-2120
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3428-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38901300Medicaid