Provider Demographics
NPI:1740832963
Name:VAN STEENBERGEN, TYLER (DC)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:
Last Name:VAN STEENBERGEN
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:PO BOX 1303
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06039-8303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:64 SOUTH CENTER STREET
Practice Address - Street 2:
Practice Address - City:MILLERTON
Practice Address - State:NY
Practice Address - Zip Code:12546-1254
Practice Address - Country:US
Practice Address - Phone:860-806-1573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2152111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor