Provider Demographics
NPI:1215664859
Name:MCKINNEY, STEVEN M (DC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:MCKINNEY
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 1:15482 GALLANT RD
Mailing Address - Street 2:
Mailing Address - City:GALLANT
Mailing Address - State:AL
Mailing Address - Zip Code:35972-3215
Mailing Address - Country:US
Mailing Address - Phone:205-353-7973
Mailing Address - Fax:888-388-1187
Practice Address - Street 1:100 ELIZABETH ST STE 427
Practice Address - Street 2:
Practice Address - City:BOAZ
Practice Address - State:AL
Practice Address - Zip Code:35957-2151
Practice Address - Country:US
Practice Address - Phone:205-353-3482
Practice Address - Fax:888-388-1187
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2023-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2748111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2748OtherLICENSE