Provider Demographics
NPI:1649678707
Name:OLIVER, STEVEN WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WILLIAM
Last Name:OLIVER
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 1:704 E MOODY BLVD UNIT 1742
Mailing Address - Street 2:
Mailing Address - City:BUNNELL
Mailing Address - State:FL
Mailing Address - Zip Code:32110-6122
Mailing Address - Country:US
Mailing Address - Phone:386-569-6459
Mailing Address - Fax:386-259-5931
Practice Address - Street 1:4490 N US HIGHWAY 1
Practice Address - Street 2:SUITE 108
Practice Address - City:BUNNELL
Practice Address - State:FL
Practice Address - Zip Code:32110-4374
Practice Address - Country:US
Practice Address - Phone:800-362-4183
Practice Address - Fax:386-456-3071
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11373111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner