Provider Demographics
NPI:1881705366
Name:HALL, STEVEN BRETT (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:BRETT
Last Name:HALL
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 1:14822 N HIGHWAY 41
Mailing Address - Street 2:
Mailing Address - City:RATHDRUM
Mailing Address - State:ID
Mailing Address - Zip Code:83858-8461
Mailing Address - Country:US
Mailing Address - Phone:208-687-7029
Mailing Address - Fax:208-687-9233
Practice Address - Street 1:14822 N HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:RATHDRUM
Practice Address - State:ID
Practice Address - Zip Code:83858-8461
Practice Address - Country:US
Practice Address - Phone:208-687-7029
Practice Address - Fax:208-687-9233
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA924111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID3529OtherID STATE INSURANCE FUND
ID135737OtherWASHINGTON L & I
ID000010029010OtherBLUE SHIELD OF IDAHO
IDC1799OtherBLUE CROSS OF IDAHO
ID1674373Medicare ID - Type Unspecified