Provider Demographics
NPI:1003294281
Name:STEIDL, HANS KONRAD (DC)
Entity type:Individual
Prefix:DR
First Name:HANS
Middle Name:KONRAD
Last Name:STEIDL
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 1:20 PANORAMA RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-8366
Mailing Address - Country:US
Mailing Address - Phone:510-427-9600
Mailing Address - Fax:
Practice Address - Street 1:1301 N DIVISION AVE
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-8268
Practice Address - Country:US
Practice Address - Phone:208-265-0610
Practice Address - Fax:208-265-9192
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-08
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1655111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor